Martins F M, de Menezes I C, Telo M C, dos Anjos R T
Unidade de Cardiologia Pediátrica, Hospital de Santa Cruz, Portugal.
Rev Port Cardiol. 1994 Jun;13(6):493-501, 476.
To assess the efficacy and safety of the percutaneous closure of the persistent ductus arteriosus with the Rashkind device.
Clinical, angiographic and echocardiographic assessment of the patency of the ductus arteriosus at the time of the implantation of the first or second Rashkind device, followed by clinical and echocardiographic control at one, three and six months and yearly thereafter.
Thirty two patients with patent ductus arteriosus. Twenty seven were female and five male. Their ages ranged between 10 months and 33 years (6.8 +/- 7.7 years) and their weights between 7.3 and 52 (20.1 +/- 12.4) kg. Two patients were excluded due to a ductal diameter greater than 8 mm. Thirty patients had successful device implantation.
Implantation at cardiac catheterization of the Rashkind double umbrella occluder device in the narrowest portion of the patent ductus arteriosus. Twenty one patients had one device implanted and five had the implantation of a second device four to 12 months later, due to persistent patency of the ductus.
Total closure was achieved in 26 out of 30 patients. In 21 patients the occlusion was obtained with a single device and in five patients with two devices. Among the remaining four patients, one is awaiting the implantation of a second device and the other three are under follow-up as their first devices were implanted recently. There were no complications.
Percutaneous closure of the ductus arteriosus with the Rashkind device represents an efficient and safe alternative to surgery in most patients.
评估使用拉什金德装置经皮闭合动脉导管未闭的有效性和安全性。
在植入第一个或第二个拉什金德装置时,对动脉导管未闭的通畅情况进行临床、血管造影和超声心动图评估,随后在1个月、3个月和6个月时进行临床和超声心动图检查,此后每年检查一次。
32例动脉导管未闭患者。其中27例为女性,5例为男性。年龄在10个月至33岁之间(平均6.8±7.7岁),体重在7.3至52千克之间(平均20.1±12.4千克)。2例因导管直径大于8毫米被排除。30例患者成功植入装置。
在心脏导管插入术中,将拉什金德双伞封堵器装置植入动脉导管未闭最窄处。21例患者植入一个装置,5例患者因导管持续通畅,在4至12个月后植入第二个装置。
30例患者中有26例实现完全闭合。21例患者通过单个装置实现封堵,5例患者通过两个装置实现封堵。其余4例患者中,1例正在等待植入第二个装置,另外3例因最近刚植入第一个装置,正在接受随访。无并发症发生。
对大多数患者而言,使用拉什金德装置经皮闭合动脉导管未闭是一种有效且安全的手术替代方法。