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经导管动脉导管未闭封堵术,我们应该使用哪种器械?

Trans-Catheter Closure of Patent Ductus Arteriosus, which device should we use?

出版信息

Tunis Med. 2021;99(11):1085-1092.

Abstract

UNLABELLED

Despite the operational experience in the percutaneous closure of Patent ductus arteriosus (PDA), complications can arise during the procedure. To overcome these complications the choice of the device must be adapted to each patient.

AIM

To report the experience of the cardiology department in the transcatheter device closure of PDA and to determine the influencing factors of choice of the device.

METHODS

Our study included patients with patent ductus arteriosus that are admitted for transcatheter closure, between September 2003 and June 2016.

RESULT

One hundred and fifty-three patients were included in our study. Transcatheter closure was not done in 9 cases. The transcatheter closure was successful in 140 patients. The complications were observed in 11 patients that includes device embolization in 3 cases, aortic protrusion in four cases pulmonary protrusion in three cases and inguinal hematoma in one another. Three predictive factors of complications were: age < 2 years, tubular PDA type C and ratio duct diameter/weight > 0.95. A mild residual shunt was observed at the end of the procedure in 22.85 % of the patients. The risk of residual shunt was significantly increased when the age < 2 years, the large PDA, the presence of pulmonary hypertension and the tubular C PDA.

CONCLUSION

The choice of the device depends essentially on age, the weight and the duct anatomy.

摘要

目的:报告心内科经导管动脉导管未闭(PDA)封堵术的经验,并确定影响封堵器选择的因素。

方法:我们的研究纳入了 2003 年 9 月至 2016 年 6 月期间因经导管闭合而入院的动脉导管未闭患者。

结果:153 例患者纳入本研究。9 例未行经导管封堵术。140 例患者经导管封堵成功。11 例患者出现并发症,包括 3 例封堵器栓塞、4 例主动脉突出、3 例肺动脉突出和 1 例腹股沟血肿。3 个预测并发症的因素为:年龄<2 岁、管状 PDA 型 C 和导管直径/体重比>0.95。22.85%的患者在操作结束时出现轻度残余分流。当年龄<2 岁、PDA 较大、存在肺动脉高压和管状 C PDA 时,残余分流的风险显著增加。

结论:封堵器的选择主要取决于年龄、体重和导管解剖结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa5d/9390122/4aabe71f8842/image1.jpg

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