Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin, Houston, TX 77030, USA.
JACC Cardiovasc Interv. 2010 Dec;3(12):1295-9. doi: 10.1016/j.jcin.2010.08.022.
We sought to analyze the outcomes of transcatheter patent ductus arteriosus (PDA) occlusion using a variety of devices in infants weighing ≤6 kg.
Indications for transcatheter closure of a PDA in infancy include congestive heart failure and/or failure to thrive. Devices available for small infants may be problematic for various reasons, including sheath size, stiffness of delivery system, and anchoring and retrievability characteristics of the device. The Amplatzer Ductal Occluder is approved by U.S. Food and Drug Administration for children weighing >6 kg and older than 6 months of age.
We performed a multicenter, retrospective analysis of children weighing ≤6 kg in whom transcatheter PDA occlusion was attempted between January 1995 and November 2005 at Texas Children's Hospital and January 2001 to November 2005 at Children's Hospital of San Diego.
A total of 62 patients underwent attempted closure. The mean age at catheterization was 4.7 ± 2.8 months with a mean weight at catheterization of 4.6 ± 0.9 kg. Successful device placement was achieved in 58 of 62 patients (94%). Among those receiving a device, complete occlusion was noted in all 58 patients at either catheterization or last available follow-up.
Percutaneous closure of PDA should be considered even in infants ≤6 kg.
我们旨在分析使用各种器械经导管治疗体重≤6kg 的婴儿动脉导管未闭(PDA)的结果。
婴儿经导管 PDA 封堵的适应证包括充血性心力衰竭和/或生长发育迟缓。由于鞘管尺寸、输送系统的硬度以及器械的锚固和可回收性特点等各种原因,适用于小婴儿的器械可能存在问题。Amplatzer 动脉导管未闭封堵器已获美国食品药品监督管理局批准,用于体重>6kg 且年龄>6 个月的儿童。
我们对德克萨斯儿童医院 1995 年 1 月至 2005 年 11 月和圣地亚哥儿童医院 2001 年 1 月至 2005 年 11 月期间接受经导管 PDA 封堵治疗的体重≤6kg 的患儿进行了多中心回顾性分析。
共有 62 例患儿接受了封堵尝试。导管插入时的平均年龄为 4.7±2.8 个月,导管插入时的平均体重为 4.6±0.9kg。62 例患儿中有 58 例(94%)成功放置了器械。在接受器械治疗的患儿中,58 例患儿在导管插入或最后一次可获得的随访中均完全闭塞。
即使是体重≤6kg 的婴儿,也应考虑采用经皮 PDA 封堵。