Park Young A, Kim Nam Kyun, Park Su-Jin, Yun Bong Sic, Choi Jae Young, Sul Jun Hee
Division of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.
Korean J Pediatr. 2010 Dec;53(12):1012-7. doi: 10.3345/kjp.2010.53.12.1012. Epub 2010 Dec 31.
Transcatheter closure has become an effective therapy in most patients with patent ductus arteriosus (PDA). However, there are difficulties in transcatheter closure of PDA in small children. We reviewed clinical outcomes of transcatheter closure of PDA in children weighing less than 10 kg in a single center.
Between January 2003 and December 2009, 314 patients with PDA underwent transcatheter closure in our institute. Among them, 115 weighed less than 10 kg. All of these patients underwent transcatheter closure of PDA using either COOK Detachable Coil®, PFM Nit-Occlud®, or Amplatzer duct occluder®. A retrospective review of the treatment results and complications was performed.
The mean age of patients was 9.1±5.9 months (median, 8 months), and mean weight was 7.6±1.8 kg (median, 7.8 kg). The mean diameter of PDA was 3.2±1.4 mm (median, 3 mm). Complete occlusion occurred in 113 patients (98%). One patient was sent to surgery because of a failed attempt at device closure, and another patient had a small residual shunt after device placement. The average mean length of hospital stay was 3.0±3.3 days, and mean follow-up duration was 21.0±19.6 months. There were no major complications in any of the patients.
Transcatheter closure of PDA is considered safe and efficacious in infants weighing less than 10 kg. With sufficient experience and further effort, transcatheter closure of PDA can be accepted as the gold standard of treatment for this group of patients.
经导管封堵术已成为大多数动脉导管未闭(PDA)患者的有效治疗方法。然而,小儿PDA的经导管封堵存在困难。我们回顾了单中心体重小于10kg儿童PDA经导管封堵的临床结果。
2003年1月至2009年12月,我院314例PDA患者接受了经导管封堵术。其中,115例体重小于10kg。所有这些患者均使用COOK可脱卸弹簧圈、PFM Nit-Occlud或Amplatzer动脉导管封堵器进行PDA经导管封堵。对治疗结果和并发症进行了回顾性分析。
患者的平均年龄为9.1±5.9个月(中位数,8个月),平均体重为7.6±1.8kg(中位数,7.8kg)。PDA的平均直径为3.2±1.4mm(中位数,3mm)。113例患者(98%)实现完全封堵。1例患者因封堵装置置入失败而接受手术,另1例患者在装置置入后有少量残余分流。平均住院时间为3.0±3.3天,平均随访时间为21.0±19.6个月。所有患者均无严重并发症。
对于体重小于10kg的婴儿,PDA经导管封堵术被认为是安全有效的。有了足够的经验和进一步的努力,PDA经导管封堵术可被接受为这类患者的治疗金标准。