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早产儿血流动力学显著的动脉导管未闭的器械封堵术

Device Closure of Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants.

作者信息

Baruteau Alban-Elouen, Méot Mathilde, Benbrik Nadir, Grunenwald Céline, Lwin Naychi, Patkai Juliana, Rozé Jean-Christophe, Bonnet Damien, Malekzadeh-Milani Sophie

机构信息

Department of Pediatric Cardiology and Pediatric Cardiac Surgery, Nantes Université, CHU Nantes, FHU PreciCare, Nantes, France.

Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, Nantes, France.

出版信息

JACC Adv. 2024 Aug 24;3(10):101211. doi: 10.1016/j.jacadv.2024.101211. eCollection 2024 Oct.

Abstract

The patent ductus arteriosus is a very common condition in preterm infants, and a hemodynamically significant patent ductus arteriosus increases morbidity and mortality in these vulnerable patients. However, despite numerous randomized controlled trials, there is no consensus regarding management. Medical therapy is typically offered as first-line treatment, although it yields limited success and carries the potential for severe adverse events. In recent years, there has been rapid development in transcatheter patent ductus arteriosus closure primary with the use of the Amplatzer Piccolo Occluder, and this has gained widespread acceptance as a safe and effective alternative to surgical ligation in extremely low-birth-weight infants weighing over 700 g. This article aims to provide an appraisal of the patient selection process, a step-by-step procedural guide, and a comprehensive review of the outcomes associated with this approach.

摘要

动脉导管未闭在早产儿中是一种非常常见的病症,而具有血流动力学意义的动脉导管未闭会增加这些脆弱患者的发病率和死亡率。然而,尽管有众多随机对照试验,但在治疗管理方面尚无共识。药物治疗通常作为一线治疗方法,尽管其成功率有限且有发生严重不良事件的可能性。近年来,使用Amplatzer Piccolo封堵器进行经导管动脉导管未闭封堵术发展迅速,对于体重超过700克的极低出生体重儿,这种方法作为手术结扎的安全有效替代方法已获得广泛认可。本文旨在对患者选择过程进行评估,提供一份逐步的操作指南,并全面综述与该方法相关的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c4a/11388744/19810846a853/ga1.jpg

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