Caixeta A M, Kajita L J, Rati M A, de Brito Júnior F S, Lima Filho M de O, Souza A N, Garcia D P, Arie S, Pileggi F
Instituto do Coração do Hospital das Clínicas, FMUSP.
Arq Bras Cardiol. 1995 Feb;64(2):121-3.
To determine the prevalence of residual left-to-right shunt in patients submitted to closure of patent ductus arteriosus with use of Rashkind double-disc ductal occluding device, analyzing predictive factors that determine short and long-term prevalence of residual shunt.
Thirteen patients were submitted to percutaneous closure of patent ductus arteriosus with use of Rashkind double-disc device. Ten patients were male with mean age of 5.7 years. A 12mm diameter device was used in 7 cases and a 17mm device in the remaining six patients. All patients had clinical, radiological and echocardiographic follow up, after 24h, 1 month, 6 months and one year after the procedure. Morphology and length of the ductus arteriosus and the presence of residual shunt after 15 min, 24h and one year after the procedure, were correlated.
In one case, embolization of the device to the pulmonary artery determined the in success of the procedure. Residual shunt was present in 75% of the patients after 15 min of the procedure, in 33.3% after 24h, in 25% after 1 month and 6 months and in 16.6% after 1 year. The most important and isolated predictive factor leading to a high prevalence of residual shunt after 24h and after 1 year of the procedure was the presence of ductus arteriosus diameter > or = 4.5mm at the site of its insertion in the pulmonary artery.
Prevalence of residual left-to-right shunt decreases over the time, with a low incidence after one year follow-up. A higher incidence of residual shunt at 24h and 1 year after the procedure occurred in the cases where the diameter of the ductus arteriosus was > or = 4.5mm, at the site of its insertion in the pulmonary artery.
确定使用拉什金德双盘导管封堵装置闭合动脉导管未闭的患者中残余左向右分流的发生率，分析决定残余分流短期和长期发生率的预测因素。
13例患者使用拉什金德双盘装置行经皮动脉导管未闭封堵术。10例为男性，平均年龄5.7岁。7例使用直径12mm的装置，其余6例使用直径17mm的装置。所有患者在术后24小时、1个月、6个月和1年后进行临床、放射学和超声心动图随访。将动脉导管的形态和长度以及术后15分钟、24小时和1年后残余分流的情况进行相关性分析。
1例患者装置栓塞至肺动脉导致手术失败。术后15分钟时75%的患者存在残余分流，24小时后为33.3%，1个月和6个月后为25%，1年后为16.6%。导致术后24小时和1年后残余分流高发生率的最重要且独立的预测因素是动脉导管在肺动脉插入部位的直径≥4.5mm。
残余左向右分流的发生率随时间降低，随访1年后发生率较低。在动脉导管于肺动脉插入部位直径≥4.5mm的病例中，术后24小时和1年时残余分流的发生率较高。
