Nour Amira, Abdelrazik Yasmeen, Huessin Safaa, Kamel Heba
Congenital and Structural Heart Disease Unit, Cardiology Department, Ain Shams University Hospital, P.O. 11835, Abbassya, Nargess 3, Fifth Settlement, Cairo, Egypt.
Pediatric Department, Sohag University, Sohâg, Egypt.
Egypt Heart J. 2022 Mar 4;74(1):14. doi: 10.1186/s43044-022-00251-3.
Transcatheter closure of patent ductus arteriosus (PDA) has gained acceptance over the last two decades, replacing the surgery in more than 90% of the cases, so the safety and efficacy of transcather closure of PDA have been evaluated by studying different experiences from different centers in developing countries. The aim is to report our experience with PDA transcather closure, with focus on the adverse events and complications faced during the procedure.
Outcome data on PDA transcatheter closure were collected from two different tertiary centers in a multicenter registry. During the period from June 2017 till January 2021, 308 PDA closure were recorded, using device in 197 (64%) and coils in 111 (36%) patients, most of the patients were in pediatric age group from 6 months to 6 years and only 10 patients (3.2%) were adults. Most patients had isolated PDA of 92%, and 9 (2.9%) patients had residual PDAs either post-surgical or transcatheter closure. Median minimum PDA diameter was 2.8 mm (range 1-7.6 mm; IQR 1.8-3.8 mm). The procedure was successful in 293 patients (95%). Complications occurred in 15/308 patients (5%), and only 6 (2%) of them were major complications, but none was life threating. Frequent complications were device embolization (2%), hemolysis (1%), arrhythmia (1%). Younger age, low body weight and longer procedure time were associated with a high complication rate (p < 0.005). Device-related complications were more common than coil-related complications (2.5% versus 0.5%).
Although transcatheter closure of PDA is considered to be effective procedure with low complications rate, however, complications should be anticipated and managed properly.
在过去二十年中，经导管封堵动脉导管未闭（PDA）已被广泛接受，超过90%的病例已取代手术治疗，因此，发展中国家不同中心的不同经验对经导管封堵PDA的安全性和有效性进行了评估。目的是报告我们经导管封堵PDA的经验，重点关注该过程中面临的不良事件和并发症。
从多中心登记处的两个不同三级中心收集了PDA经导管封堵的结果数据。在2017年6月至2021年1月期间，记录了308例PDA封堵病例，其中197例（64%）使用封堵器，111例（36%）使用弹簧圈，大多数患者为6个月至6岁的儿童年龄组，只有10例患者（3.2%）为成人。大多数患者（92%）为单纯PDA，9例（2.9%）患者在手术或经导管封堵后有残余PDA。PDA最小直径中位数为2.8mm（范围1-7.6mm；四分位间距1.8-3.8mm）。293例患者（95%）手术成功。15/308例患者（5%）出现并发症，其中只有6例（2%）为严重并发症，但均无生命危险。常见并发症为封堵器栓塞（2%）、溶血（1%）、心律失常（1%）。年龄较小、体重较低和手术时间较长与高并发症发生率相关（p<0.005）。封堵器相关并发症比弹簧圈相关并发症更常见（2.5%对0.5%）。
尽管经导管封堵PDA被认为是一种有效的手术，并发症发生率较低，但是，仍应预期并妥善处理并发症。
