Santiago Justo, Acuña Manuel, Arispe Elizabeth, Camargo Ronaldo, Neves Juliana, Arnoni Daniel, Fontes Valmir F, Pedra Carlos A
Servicio Médico de Intervenciones en Cardiopatías Congénitas, Instituto Dante Pazzanese de Cardiología, São Paulo, SP, Brasil.
Rev Esp Cardiol. 2007 Mar;60(3):319-22.
The association of a right aortic arch with an ipsilateral patent ductus arteriosus is rare, especially when there are no other intracardiac anomalies. We report three female patients aged 26, 35 and 9 years with this combination in whom previous attempts at surgical closure by thoracotomy and sternotomy were unsuccessful and who subsequently underwent successful percutaneous closure of the defects using Amplatzer devices. In two patients, although angiography demonstrated the presence of type-A patent ductus arteriosus, it was not possible to determine the minimum diameter accurately and it was necessary to measure it using a sizing balloon. An Amplatzer duct occluder was used in two patients and an Amplatzer muscular ventricular septal defect occluder, in the other. In all patients, full closure was confirmed in the catheterization laboratory and the patients were discharged on the same day with no complications. Percutaneous closure of a right patent ductus arteriosus associated with a right aortic arch is feasible, safe and effective.
右位主动脉弓合并同侧动脉导管未闭的情况较为罕见,尤其是在没有其他心内异常的情况下。我们报告了3例年龄分别为26岁、35岁和9岁的女性患者,她们均为此种组合情况,此前经胸壁切开术和胸骨切开术进行手术闭合的尝试均未成功,随后使用Amplatzer装置成功进行了经皮缺损闭合。在2例患者中,尽管血管造影显示为A型动脉导管未闭,但无法准确确定最小直径,因此有必要使用测量球囊进行测量。2例患者使用了Amplatzer动脉导管封堵器,另1例使用了Amplatzer肌部室间隔缺损封堵器。所有患者在导管室均确认完全闭合,患者于同日出院,无并发症。经皮闭合与右位主动脉弓相关的右位动脉导管未闭是可行、安全且有效的。