Ullah Maad, Sultan Mehboob, Akhtar Khurram, Sadiq Nadeem, Akbar Hajira
Department of Paediatrics Cardiology, Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi.
J Coll Physicians Surg Pak. 2014 Aug;24(8):581-5.
To evaluate the results and complications associated with transcatheter closure of patent ductus arteriosus (PDA) in infants.
Quasi-experimental study.
Paediatric Cardiology Department of Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from December 2010 to June 2012.
Infants undergoing transcatheter device closure of PDA were included. All patients were evaluated by experienced Paediatric Cardiologists with 2-D echocardiography and Doppler before the procedure. Success of closure and complications were recorded.
The age of patients varied from 05 - 12 months and 31 (56.4%) were females. Out of the 55 infants, 3 (5.4%) were not offered device closure after aortogram (two large tubular type ducts and one tiny duct, considered unsuitable for device closure); while in 50 (96.1%) patients out of remaining 52, the duct was successfully closed with transcatheter PDA device or coil. In one infant, device deployment resulted in acquired coarctation, necessitating device retrieval by Snare followed by surgical duct interruption and another patient had non-fatal cardiac arrest during device deployment leading to abandonment of procedure and subsequent successful surgical interruption. Local vascular complications occurred in 12 (21.8%) of cases and all were satisfactorily treated.
Transcatheter device closure of PDA in infants was an effective procedure in the majority of cases; however, here were considerable number of local access site vascular complications.
评估婴儿动脉导管未闭(PDA)经导管封堵术的结果及并发症。
准实验研究。
2010年12月至2012年6月,拉瓦尔品第武装部队心脏病学研究所/国家心脏病研究所(AFIC/NIHD)儿科心脏病科。
纳入接受PDA经导管器械封堵术的婴儿。所有患者在术前均由经验丰富的儿科心脏病专家通过二维超声心动图和多普勒进行评估。记录封堵成功率及并发症情况。
患者年龄在5至12个月之间,31例(56.4%)为女性。55例婴儿中,3例(5.4%)在主动脉造影后未进行器械封堵(2例为大的管状导管,1例为微小导管,被认为不适合器械封堵);在其余52例中的50例(96.1%)患者中,导管通过经导管PDA器械或线圈成功封堵。1例婴儿在器械植入时导致获得性缩窄,需用圈套器取出器械,随后进行外科导管切断术;另1例患者在器械植入过程中发生非致命性心脏骤停,导致手术放弃,随后外科手术切断导管成功。12例(21.8%)发生局部血管并发症,均得到满意治疗。
婴儿PDA经导管器械封堵术在大多数情况下是有效的;然而,存在相当数量的局部穿刺部位血管并发症。