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使用Occlutech动脉导管封堵器闭合动脉导管未闭:南非伊丽莎白港的经验

Patent ductus arteriosus closure using Occlutech Duct Occluder, experience in Port Elizabeth, South Africa.

作者信息

Pepeta Lungile, Greyling Adele, Nxele Mahlubandile Fintan, Makrexeni Zongezile Masonwabe

机构信息

Department of Paediatrics and Child Health, Division of Paediatric Cardiology, Dora Nginza Hospital, Walter Sisulu University, Port Elizabeth, South Africa.

出版信息

Ann Pediatr Cardiol. 2017 May-Aug;10(2):131-136. doi: 10.4103/0974-2069.205144.

Abstract

BACKGROUND

Percutaneous closure of patent ductus arteriosus (PDA) has become standard therapy. Experience with the Occlutech® Duct Occluder is limited.

METHODS

Data regarding ductal closure using Occlutech® Duct Occluder were reviewed and prospectively collected. Demographics, hemodynamic and angiographic characteristics, complications, and outcomes were documented.

RESULTS

From March 2013 to June 2016, 65 patients (43 females and 22 males) underwent percutaneous closure of the PDA using Occlutech® Duct Occluder. The median age of the patients was 11 months (range, 1-454 months) and the median weight was 8.5 kg (range 2.5-78 kg). The mean pulmonary artery median pressure was 27 mmHg (range, 12-100 mmHg) and the QP: Qs ratio median was 1.8 (range, 1-7.5), with a pulmonary vascular resistance mean of 2.7 WU (standard deviation [SD] ±2.1). Thirty-two patients had Krichenko Type A duct (49%); 7, Type C (11%); 4, Type D (6%); and 22, Type E (34%). The ductal size (narrowest diameter at the pulmonic end) mean was 3.5 mm (SD ± 1.9 mm). The screening time mean was 17.3 min (SD ± 11.6). Out of 63 patients with successful closure of the PDA using Occlutech® Duct Occluder, there were 15 patients with small PDAs; 25 with moderate PDAs, and 23 with large PDAs. In one patient, the device dislodged to the descending aorta, and in two patients, to the right pulmonary artery immediately following deployment, with successful percutaneous (two) and surgical (one) retrieval. Complete ductal occlusion was achieved in all 63 patients on day one.

CONCLUSION

The Occlutech® Duct Occluder is a safe and effective device for closure of ducts in appropriately selected patients.

摘要

背景

经皮闭合动脉导管未闭(PDA)已成为标准治疗方法。关于Occlutech®动脉导管封堵器的经验有限。

方法

回顾并前瞻性收集使用Occlutech®动脉导管封堵器进行导管闭合的数据。记录人口统计学、血流动力学和血管造影特征、并发症及结果。

结果

2013年3月至2016年6月,65例患者(43例女性和22例男性)使用Occlutech®动脉导管封堵器经皮闭合PDA。患者的中位年龄为11个月(范围1 - 454个月),中位体重为8.5 kg(范围2.5 - 78 kg)。平均肺动脉中位压力为27 mmHg(范围12 - 100 mmHg),QP:Qs比值中位数为1.8(范围1 - 7.5),肺血管阻力平均值为2.7 WU(标准差[SD]±2.1)。32例患者为克里琴科A型导管(49%);7例为C型(11%);4例为D型(6%);22例为E型(34%)。导管大小(肺动脉端最窄直径)平均值为3.5 mm(SD±1.9 mm)。筛查时间平均值为17.3分钟(SD±11.6)。在63例使用Occlutech®动脉导管封堵器成功闭合PDA的患者中,15例为小型PDA;25例为中型PDA,23例为大型PDA。1例患者封堵器脱入降主动脉,2例患者在释放后立即脱入右肺动脉,其中2例经皮成功取出,1例经手术取出。所有63例患者在第1天均实现导管完全闭塞。

结论

Occlutech®动脉导管封堵器是一种用于在适当选择的患者中闭合导管的安全有效的装置。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4807/5431024/ac8799932d14/APC-10-131-g001.jpg

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