Amoozgar Hamid, Salehi Sara, Farhadi Pouya, Edraki Mohammad Reza, Borzoee Mohammad, Ajami Gholamhossein, Cheriki Sirous, Mohammadi Hamid
Neonatology and Cardiac Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Iran J Pediatr. 2016 May 10;26(3):e3621. doi: 10.5812/ijp.3621. eCollection 2016 Jun.
Transcatheter patent ductus arteriosus (PDA) closure is an established procedure.
The aim of the study was to assess midterm follow up of the Nit-Occlud coil and the amplatzer ductal occluder (ADO) closure of PDA.
In this cohort study, we collected the longitudinal data of patients who underwent percutaneous closure using coil or ADO from November 2005 to November 2013. A total of 404 patients with PDA closure by devices were included during the study period. Coil occlusion was performed in 220 patients and 184 patients underwent catheterization using ADO. Follow-up evaluations were performed with echocardiography at two weeks, two months, six months, and during the study period (in average 4.8 ± 3.8 years).
The patients' mean age was 24 months (range: 1 - 312). The catheterization was successful in 393 (97.2%) patients and unsuccessful in 11 (2.7%). Immediate complete occlusion was seen in 290 (73.7 %) patients. The occlusion rates at two weeks, two months, six months, and during the study period were 73.7%, 84%, 93.6%, 98.7%, and 99.5%, respectively. Complications occurred in 23 (5.8%) patients during or immediately after the catheterization, and device embolization with 2.7% was the most common complication. Most complications occurred in a patient with pulmonary hypertension who was less than one year old and was undergoing the first year of experience with devices.
Our findings showed that transcatheter occlusion of the PDA is an effective and safe intervention by coil or Amplatzer with excellent early and one-year outcomes. Pulmonary hypertension, age of less than 12 months and experience of less than one year may increase the complications of device closure.
经导管动脉导管未闭（PDA）封堵术是一种成熟的手术。
本研究旨在评估 Nit-Occlud 线圈和 Amplatzer 动脉导管封堵器（ADO）封堵 PDA 的中期随访情况。
在这项队列研究中，我们收集了 2005 年 11 月至 2013 年 11 月期间接受线圈或 ADO 经皮封堵术患者的纵向数据。研究期间共纳入 404 例接受器械封堵 PDA 的患者。220 例患者采用线圈封堵，184 例患者使用 ADO 进行导管介入治疗。在术后两周、两个月、六个月以及研究期间（平均 4.8±3.8 年）进行超声心动图随访评估。
患者的平均年龄为 24 个月（范围：1 - 312 个月）。393 例（97.2%）患者导管介入治疗成功，11 例（2.7%）失败。290 例（73.7%）患者即刻完全封堵。术后两周、两个月、六个月以及研究期间的封堵率分别为 73.7%、84%、93.6%、98.7%和 99.5%。23 例（5.8%）患者在导管介入治疗期间或术后即刻出现并发症，器械栓塞发生率为 2.7%，是最常见的并发症。大多数并发症发生在年龄小于 1 岁、患有肺动脉高压且首次接受器械治疗的患者中。
我们的研究结果表明，经导管封堵 PDA 是一种有效且安全的干预措施，使用线圈或 Amplatzer 封堵器均具有良好的早期和一年期疗效。肺动脉高压、年龄小于 12 个月以及治疗经验少于 1 年可能会增加器械封堵的并发症。
