Rush Center for Congenital and Structural Heart Disease Rush University Medical Center, Chicago, IL, USA.
Catheter Cardiovasc Interv. 2013 Oct 1;82(4):534-40. doi: 10.1002/ccd.24522. Epub 2013 Jun 29.
To describe early clinical experience with the amplatzer ductal occluder II additional sizes (ADO II AS) for percutaneous arterial duct occlusion in infants and small children.
Pre-, intra- and postprocedural data analysis of all patients undergoing arterial duct occlusion with the ADO II AS from three tertiary referral centers.
17 patients (10 female) with a median age of 6 months (range 1.0-48.1 months) and a median weight of 5.7 kg (range 1.7-17.4 kg) underwent attempted transcatheter ductal closure with the ADO II AS. Retrograde arterial approach was used in eight patients with transvenous femoral approach used in nine. The mean minimal ductal diameter was 2.2 ± 0.7 mm with mean ductal length of 6.8 ± 1.7 mm. Device sizes used were 5/6 (n = 5), 3/4 (n = 4), 4/4 (n = 3), 4/6 (n = 3), and 5/4 (n = 2) with four French delivery sheaths used in all cases. The median fluoroscopy time was 5.7 ± 1.8 min. Two patients underwent delivery under exclusive echocardiography guidance. Complete ductal occlusion was achieved by the end of the procedure in 13 patients. Device embolization to the left pulmonary artery occurred in one patient with successful surgical removal and ligation of the arterial duct. Three patients required device resizing following deployment of the initial device. Complete ductal occlusion without aortic arch or left pulmonary artery stenosis has been identified in all 16 remaining patients on transthoracic echocardiographic follow-up at median of 4.2 months.
The new amplatzer ductal occluder II AS achieves excellent ductal closure rates through low profile delivery systems in small infants and children with variable ductal anatomy.
描述应用新型 Amplatzer 动脉导管未闭封堵器（ADO II AS）经皮治疗婴儿及小龄儿童动脉导管未闭的早期临床经验。
对三家三级转诊中心应用 ADO II AS 治疗的所有患者的术前、术中及术后资料进行分析。
17 例患者（女 10 例），中位年龄 6 个月（1.0-48.1 个月），中位体重 5.7kg（1.7-17.4kg），采用 ADO II AS 尝试经导管动脉导管未闭封堵术。8 例采用逆行股动脉入路，9 例采用顺行股静脉入路。最小动脉导管直径为 2.2±0.7mm，平均导管长度为 6.8±1.7mm。使用的封堵器型号为 5/6（n=5）、3/4（n=4）、4/4（n=3）、4/6（n=3）和 5/4（n=2），所有病例均使用 4Fr 输送鞘管。透视时间中位数为 5.7±1.8min。2 例患者仅在超声心动图引导下进行输送。13 例患者在手术结束时完全闭塞导管。1 例患者发生封堵器栓塞至左肺动脉，成功进行了外科取出和动脉导管结扎。3 例患者在初次植入封堵器后需要调整封堵器大小。16 例患者（94%）在中位时间为 4.2 个月的经胸超声心动图随访中完全闭塞导管，无主动脉弓或左肺动脉狭窄。
新型 Amplatzer 动脉导管未闭封堵器 AS 采用小外径输送系统，可在小婴儿和儿童中实现优异的导管闭合率，适用于各种不同的动脉导管解剖结构。
