Bilici Meki, Demir Fikri, Akın Alper, Türe Mehmet, Balık Hasan, Kuyumcu Mahir
Department of Pediatric Cardiology, Dicle University Medical Faculty, Sur, Diyarbakır, Turkey.
Department of Anesthesiology, Dicle University Medical Faculty, Sur, Diyarbakir, Turkey.
Pediatr Cardiol. 2017 Dec;38(8):1598-1605. doi: 10.1007/s00246-017-1702-x. Epub 2017 Aug 21.
The aim of this study was to evaluate the feasibility, efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with the Occlutech duct occluder (ODO) in children. We reviewed the clinical records of 71 patients who underwent percutaneous closure of PDA with an ODO between September 2014 and August 2016. The Occlutech duct occluder was applied to 71 patients during the study period (September 2014-August 2016), and the results were analyzed in this study. Forty-two of the patients were female and 29 male. The median age was 20.5 months (range, 6-194 months) and median weight was 16 kg (range, 6-68 kg). The PDA was classified as type A in 54 patients (76.1%), type E in 14 (19.7%), type C in 2 (2.8%) and type B in 1 (1.4%) based on the Krichenko classification. A standard ODO device was used for the transcatheter closure procedure in 66 patients and the long-shank ODO device in 5. In the echocardiographic measurement of PDA, the median smallest diameter was 2.7 mm (range, 1.5-7.0 mm), and in the angiographic measurement, the median smallest diameter was 2.5 mm (range, 1.5-6.5 mm). All 71 patients underwent successful PDA closure with the ODO. Angiography following the procedure showed complete closure in 47 patients (66.2%), mild residual shunt in 13 patients (18.3%) and a trivial shunt in 11 patients (15.5%). Color flow Doppler echocardiogpaphy at 24 h post-implantation showed that complete closure was achieved in 65 patients (91.5%), and 6 patients (8.5%) had mild residual shunt. All patients (100%) had complete closure at 30 days of follow-up. The results of this study showed that the Occlutech PDA occluder device is safe and effective in the closure of PDA. As the pulmonary artery side of the device is wider than the aortic side, protrusion toward the aortic side and embolization are prevented, but there is residual shunt in the early period, although this residual shunt disappeared after a few months.
本研究的目的是评估使用Occlutech动脉导管封堵器（ODO）经导管闭合小儿动脉导管未闭（PDA）的可行性、有效性和安全性。我们回顾了2014年9月至2016年8月期间71例行ODO经皮闭合PDA患者的临床记录。在研究期间（2014年9月至2016年8月），71例患者应用了Occlutech动脉导管封堵器，并对结果进行了本研究分析。患者中42例为女性，29例为男性。年龄中位数为20.5个月（范围6 - 194个月），体重中位数为16 kg（范围6 - 68 kg）。根据克里琴科分类，54例（76.1%）PDA为A型，14例（19.7%）为E型，2例（2.8%）为C型，1例（1.4%）为B型。66例患者在经导管闭合手术中使用标准ODO装置，5例使用长柄ODO装置。在PDA的超声心动图测量中，最小直径中位数为2.7 mm（范围1.5 - 7.0 mm），在血管造影测量中，最小直径中位数为2.5 mm（范围1.5 - 6.5 mm）。所有71例患者均使用ODO成功闭合PDA。术后血管造影显示47例（66.2%）完全闭合，13例（18.3%）有轻度残余分流，11例（15.5%）有微量分流。植入后24小时彩色多普勒超声心动图显示65例（91.5%）实现完全闭合，6例（8.5%）有轻度残余分流。所有患者（100%）在随访30天时均完全闭合。本研究结果表明，Occlutech PDA封堵器装置在闭合PDA方面安全有效。由于该装置肺动脉侧比主动脉侧宽，可防止向主动脉侧突出和栓塞，但早期存在残余分流，不过这种残余分流在几个月后消失。
