经导管应用 Amplatzer 动脉导管未闭封堵器关闭婴儿中型至大型动脉导管未闭。
Transcatheter closure of moderate-to-large patent ductus arteriosus in infants using Amplatzer duct occluder.
机构信息
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
出版信息
Circ J. 2010 Feb;74(2):361-4. doi: 10.1253/circj.cj-09-0473. Epub 2009 Dec 22.
BACKGROUND
There are difficulties in transcatheter closure of patent ductus arteriosus (PDA) in infants.
METHODS AND RESULTS
The 46 infants (mean age 6.2+/-2.7 months; mean body weight 6.3+/-1.6 kg) who underwent PDA closure using the Amplatzer duct occluder (ADO). The indication for using an ADO was a ductus diameter > or =2.5 or 3 mm. Device diameter selected was 1-3 mm larger than ductal diameter. The mean systolic pulmonary artery pressure was 40.9+/-18.2 mmHg. The mean Qp/Qs ratio was 3.1+/-1.2. The mean ductus diameter was 3.3+/-0.8 mm. ADO was successfully deployed in 45 patients. Failure occurred in 1 case. The mean diameter of device used was 5.4+/-1.1 mm. No severe complications occurred. At the 1-month echocardiographic follow-up, a small residual shunt was present in 4 of 45 patients and had disappeared in all 4 patients at the 3-month follow-up. One patient developed a moderate degree of left ventricular outflow tract obstruction 2.3 years after the procedure.
CONCLUSIONS
Transcatheter closure of PDA in infants using the ADO is a safe and effective method.
背景
经导管动脉导管未闭（PDA）封堵术在婴幼儿中存在一定难度。
方法和结果
46 例婴儿（平均年龄 6.2+/-2.7 个月；平均体重 6.3+/-1.6 公斤）采用 Amplatzer 动脉导管未闭封堵器（ADO）进行 PDA 封堵。使用 ADO 的指征为动脉导管直径≥2.5 或 3mm。选择的器械直径比导管直径大 1-3mm。平均收缩期肺动脉压为 40.9+/-18.2mmHg。平均 Qp/Qs 比值为 3.1+/-1.2。平均动脉导管直径为 3.3+/-0.8mm。45 例患者成功放置 ADO，1 例失败。使用的器械平均直径为 5.4+/-1.1mm。无严重并发症发生。在 1 个月的超声心动图随访中，45 例患者中有 4 例存在小残余分流，所有患者在 3 个月随访时均消失。1 例患者在术后 2.3 年出现中度左心室流出道梗阻。
结论
采用 ADO 经导管婴幼儿 PDA 封堵术是一种安全有效的方法。
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