Ren S G, Lu J X, Kang K
117th Hospital of PLA.
Zhonghua Nei Ke Za Zhi. 1990 May;29(5):283-5, 317.
Percutaneous plug closure of arterial duct (AD) was performed on 38 patients, with ages ranging from 6 to 54 years. The inside diameter of AD varied from 3.7 to 11.6 mm and the shunt size of AD was 8-77% of the pulmonary flow. A combined technique was used in the closure operation, which employs a balloon catheter to explore the size of AD as well as its distensibility and a catheter scale to examine the compatibility of the foam plug with the AD to be closed. Total occlusion was achieved in all the 38 cases, the success rate being 100%. Immediately after the procedure, blood oxygen analysis showed an interruption of the left-to-right shunt and the pulmonary artery pressure decreased from 4.71 +/- 0.80 to 3.34 +/- 0.53 kPa (P less than 0.001). Four to 7 days later, the cardiothoracic ratio reduced from 52.8 +/- 4.6 to 49.7 +/- 4.2% (P less than 0.001) and the cardiac index decreased from 6.00 +/- 1.31 to 4.46 +/- 0.80 L/min.m-2 (P less than 0.001). Random color Doppler flow imaging suggested no residual shunts. No major complications were observed in any of the cases and follow-up observations in 1 to 24 months showed no plug displacement or recanalization.
the balloon exploration is able to make certain of the "occlusion diameter" of AD and the scale examination can surely sort out the plug most compatible with the AD to be closed, so that success of every step for the closure is ensured.
对38例年龄在6至54岁的患者进行了动脉导管（AD）的经皮封堵术。AD的内径为3.7至11.6毫米，AD的分流量为肺血流量的8 - 77%。封堵手术采用了联合技术，即使用球囊导管探测AD的大小及其可扩张性，并使用导管测量仪检查泡沫封堵器与待封堵AD的适配性。38例患者均实现完全封堵，成功率为100%。术后即刻，血氧分析显示左向右分流中断，肺动脉压从4.71±0.80降至3.34±0.53千帕（P＜0.001）。4至7天后，心胸比率从52.8±4.6降至49.7±4.2%（P＜0.001），心脏指数从6.00±1.31降至4.46±0.80升/分钟·米²（P＜0.001）。随机彩色多普勒血流成像显示无残余分流。所有病例均未观察到重大并发症，1至24个月的随访观察显示无封堵器移位或再通。
球囊探测能够确定AD的“封堵直径”，测量仪检查能够准确筛选出与待封堵AD最适配的封堵器，从而确保封堵术每一步的成功。
