Munayer Calderón J, Ramírez Reyes H, Aldana Pérez T, San Luis Miranda R, Maza Juárez G, Lázaro Castillo J L, Campos A, Quintero L R, León J L
Hemodinámia Pediátrica H.G. C.M.N. La Raza, IMSS, México, D.F.
Arch Inst Cardiol Mex. 1999 Nov-Dec;69(6):554-8.
We present our early experience with the Gianturco-Grifka device for transcatheter closure of patent ductus arteriosus. Grifka occlusion was attempted in 13 patients (7 female, 6 male), median patient age was 6.5 years. Echocardiographic evaluation showed a mean ductal diameter of 5.47 +/- 1.09 mm, and the morphology was type C in 7 patients, type A in 5 and type E in 1 patient. The angiographic ductal morphology was 6 type A, 5 type C and 2 type E. Mean PDA diameter was 5.69 +/- 1.15 mm. Three patients had pulmonary hypertension. They were given supplemental oxygen (100%), decreasing their pulmonary pressures. A total of 13 devices were implanted, 5 of 7 mm and 8 of 9 mm. Twelve patients had complete ductal occlusion documented by aortic angiography (92%), one patient presented residual shunt (8%). Color echocardiography at 24 hrs documented complete occlusion in 12 cases. One device embolized to the descending aorta 2 hours after closure, and it was successfully retrieved in the catheterization lab. We conclude that the Gianturco-Grifka device is an appropriate alternative for transcatheter closure of the PDA. This technique can be performed in ductus arteriosus type C, D and E, with diameter < 9 mm. More clinical trials are needed to establish the long-term results of this technique.
我们介绍了使用Gianturco-Grifka装置经导管闭合动脉导管未闭的早期经验。对13例患者（7例女性，6例男性）尝试进行Grifka封堵，患者年龄中位数为6.5岁。超声心动图评估显示动脉导管平均直径为5.47±1.09mm，7例患者形态为C型，5例为A型，1例为E型。血管造影显示动脉导管形态6例为A型，5例为C型，2例为E型。动脉导管未闭平均直径为5.69±1.15mm。3例患者有肺动脉高压。给予他们100%的补充氧气，降低了他们的肺动脉压力。共植入13个装置，7mm的5个，9mm的8个。12例患者经主动脉造影证实动脉导管完全闭塞（92%），1例患者出现残余分流（8%）。24小时彩色超声心动图证实12例完全闭塞。1个装置在闭合后2小时栓塞至降主动脉，并在导管室成功取出。我们得出结论，Gianturco-Grifka装置是经导管闭合动脉导管未闭的合适替代方法。该技术可用于C型、D型和E型且直径<9mm的动脉导管。需要更多的临床试验来确定该技术的长期结果。
