[139例成人动脉导管未闭患者经导管封堵术的疗效]

[Effects of transcatheter closure of patent ductus arteriosus in 139 adult patients].

作者信息

Zhu Xian-Yang, Chen Huo-Yuan, Zhang Duan-Zhen, Han Xiu-Min, Sheng Xiao-Tang, Cui Chun-Sheng, Zhang Po, Wang Qi-Guang

机构信息

Department of Congenital Heart Disease, General Hospital of Shenyang Military Region, Shenyang 110016, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Nov;37(11):998-1000.

PMID:20137324

Abstract

OBJECTIVE

To analyze the clinical feature and the effects of transcatheter closure of adult patients with patent ductus arteriosus (PDA).

METHODS

Between January 2000 and April 2009, 139 patients [22 male, aged from 40 to 74: (49.8 +/- 6.8) years] with PDA were hospitalized in our hospital. Clinical data and effects of transcatheter closure of PDA were analyzed.

RESULTS

There were 64 patients with NYHA classI, 53 with class II, 16 with class III and 6 with class IV before procedure. In 139 patients, pulmonary arterial hypertension (PAH) was found in 107 out of 139 patients (77.0%). Transcatheter PDA closure was not performed in 3 patients due to severe PAH and successfully performed in the remaining 136 patients (97.8%) without major complications. Post procedure aortic angiography evidenced minor residual shunt in 14 cases, small residual shunt in 2 cases and moderate shunt in 1 case. The NYHA class was significantly improved and the PAH significantly reduced [sPAP: (47.3 +/- 23.9) mm Hg (1 mm Hg = 0.133 kPa) vs. (28.1 +/- 12.3) mm Hg, P < 0.01] post procedure.

CONCLUSION

PAH and heart failure were commonly associated with PDA in adult patients. Transcatheter PDA closure is safe and effective in these patients except those with severe PAH.

摘要

目的

分析成人动脉导管未闭（PDA）患者的临床特征及经导管封堵术的疗效。

方法

2000年1月至2009年4月，我院收治139例PDA患者[男22例，年龄40～74岁，平均（49.8±6.8）岁]。分析PDA患者的临床资料及经导管封堵术的疗效。

结果

术前纽约心脏病协会（NYHA）心功能分级Ⅰ级64例，Ⅱ级53例，Ⅲ级16例，Ⅳ级6例。139例患者中，107例（77.0%）存在肺动脉高压（PAH）。3例因重度PAH未行PDA经导管封堵术，其余136例（97.8%）封堵成功，无严重并发症。术后主动脉造影显示14例有少量残余分流，2例有小量残余分流，1例有中度分流。术后NYHA心功能分级明显改善，PAH明显降低[收缩期肺动脉压：（47.3±23.9）mmHg（1mmHg = 0.133kPa）对比（28.1±12.3）mmHg，P < 0.01]。