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经导管动脉导管未闭封堵术在低体重婴儿中的应用。

Catheter-based closure of the patent ductus arteriosus in lower weight infants.

机构信息

Center for Perinatal Research, Nationwide Children's Hospital, Columbus, OH.

Center for Perinatal Research, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics at The Ohio State University Wexner Medical Center, Columbus, OH.

出版信息

Semin Perinatol. 2018 Jun;42(4):262-268. doi: 10.1053/j.semperi.2018.05.009. Epub 2018 Jun 13.

Abstract

Risks associated with drug therapy and surgical ligation have led health care providers to consider alternative strategies for patent ductus arteriosus (PDA) closure. Catheter-based PDA closure is the procedure of choice for ductal closure in adults, children, and infants ≥6kg. Given evidence among older counterparts, interest in catheter-based closure of the PDA in lower weight (<6kg) infants is growing. Among these smaller infants, the goals of this review are to: (1) provide an overview of the procedure; (2) review the types of PDA closure devices; (3) review the technical success (feasibility); (4) review the risks (safety profile); (5) discuss the quality of evidence on procedural efficacy; (6) consider areas for future research. The review provided herein suggests that catheter-based PDA closure is technically feasible, but the lack of comparative trials precludes determination of the optimal strategy for ductal closure in this subgroup of infants.

摘要

药物治疗和手术结扎相关的风险促使医疗保健提供者考虑用于动脉导管未闭(PDA)闭合的替代策略。导管介入 PDA 闭合是成人、儿童和≥6kg 婴儿进行导管闭合的首选方法。鉴于老年患者的相关证据,人们对导管介入 PDA 闭合在较低体重(<6kg)婴儿中的应用越来越感兴趣。在这些较小的婴儿中,本次综述的目的是:(1)概述该手术过程;(2)回顾 PDA 闭合装置的类型;(3)回顾技术成功率(可行性);(4)回顾风险(安全性概况);(5)讨论手术疗效的证据质量;(6)考虑未来研究的领域。本文综述表明,导管介入 PDA 闭合在技术上是可行的,但缺乏对照试验使得无法确定该亚组婴儿的最佳导管闭合策略。

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