Kaya Yüksel, Bulut Mustafa Orhan, Yurtdaş Mustafa, Karakurt Ahmet, Güvenç Tolga Sinan, Söylemez Nihat, Güler Ahmet, Gönüllü Edip, Ceylan Yemlihan, Akdemir Ramazan
Department of Cardiology, Kafkas University Faculty of Medicine, Kars, Turkey.
Turk Kardiyol Dern Ars. 2013 Jun;41(4):310-8. doi: 10.5543/tkda.2013.72693.
To evaluate short term results of percutaneous patent ductus arteriosus (PDA) closure in a cohort of pediatric and adult patients following closure with the Amplatzer Ductal Occluder (ADO-1 and ADO-2) and Amplatzer Septal Occluder (ASO) devices.
A total of 48 patients (17 male and 31 female; range 3 to 39 years) were included in this study. All patients were evaluated with transthoracic echocardiography (TTE) before intervention. Percutaneous closure was performed under fluoroscopy through anterograde or retrograde route. Aortagraphy was performed to measure and classify the ductus arteriosus. Residual shunt through ductus was controlled by aortography at the tenth minute and by TTE 24 hours and three months after the procedure.
The released device was ADO-1 in 25 patients (51.2%), ADO-2 in 22 patients (45.8%), and ASO in one patient. Mean follow-up was 13.2 months. In 97.9% of patients, the occluder was placed into the ductus without any complication. In one patient, the device embolized to the left pulmonary artery during implantation. Aortography performed ten minutes after the procedure showed complete closure in 38 patients without residual defect. TTE revealed trace amounts of residual shunt within the device in two patients, flow around the device in two patients 24 hours after implantation, and residual shunt in only one patient three month after intervention.
Transcatheter closure of PDA with ADO-1 and ADO-2 devices has low morbidity and mortality with high rates of success in selected patients.
评估使用Amplatzer动脉导管封堵器（ADO - 1和ADO - 2）及Amplatzer房间隔封堵器（ASO）对小儿和成年患者进行经皮动脉导管未闭（PDA）封堵的短期效果。
本研究共纳入48例患者（男性17例，女性31例；年龄范围3至39岁）。所有患者在干预前均接受经胸超声心动图（TTE）检查。在透视引导下经顺行或逆行途径进行经皮封堵。进行主动脉造影以测量和分类动脉导管。术后第10分钟通过主动脉造影控制动脉导管残余分流，术后24小时和3个月通过TTE控制。
25例患者（51.2%）释放的封堵器为ADO - 1，22例患者（45.8%）为ADO - 2，1例患者为ASO。平均随访时间为13.2个月。97.9%的患者封堵器放置于动脉导管内且无任何并发症。1例患者在植入过程中封堵器栓塞至左肺动脉。术后10分钟进行的主动脉造影显示38例患者完全封堵且无残余缺损。TTE显示2例患者封堵器内有微量残余分流，2例患者在植入后24小时封堵器周围有血流，干预后3个月仅1例患者有残余分流。
使用ADO - 1和ADO - 2装置经导管封堵PDA在特定患者中具有低发病率和死亡率以及高成功率。
