Ledesma Velasco M, David Gómez F, Alva Espinoza C, Montoya Guerrero S A, Antezana Castro J, Garrido Garduño M H, Argüero Sánchez R
Hospital de Cardiología Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F.
Arch Inst Cardiol Mex. 1995 Jul-Aug;65(4):349-58.
Thirty eight transcatheter umbrella closure (TUC) of a persistently patent ductus arteriosus using the Rashkind umbrella occluder (USCI), were attempted in thirty four patients. Mean age 8.5 +/- 9.0 years (range 1.5 to 31). Internal diameter of ductus arteriosus (DA) average 4.0 +/- 1.5 mm (range 2 to 9 mm). Successful implantation was achieved in 36 procedures (94.7%). Complete closure immediately postimplantation was achieved in 15 (45.4%), 12 (36.3%) had trivial and 6 (18.1%) severe residual shunt. In four cases we implanted successfully a second device. At the follow-up (average 24 months) in 31 patients, 87.0% (n = 27) had complete closure and 96.7% (n = 30) did not need another intervention. Device embolization to distal left pulmonary artery occurred in two cases (5.2%), one was retrieved by surgery and in the other case it was allowed to remain. No mortality was observed. This results confirm the efficacy, with low morbidity and no mortality of TUC, especially in those with smaller PDA (< 4 mm).
对34例患者尝试使用拉什金德封堵器(USCI)经导管封堵38例动脉导管未闭(PDA)。平均年龄8.5±9.0岁(范围1.5至31岁)。动脉导管(DA)内径平均4.0±1.5毫米(范围2至9毫米)。36例手术(94.7%)成功植入。植入后立即完全封堵的有15例(45.4%),12例(36.3%)有微量残余分流,6例(18.1%)有严重残余分流。4例成功植入第二个装置。在31例患者的随访中(平均24个月),87.0%(n = 27)实现完全封堵,96.7%(n = 30)无需再次干预。2例(5.2%)发生封堵器栓塞至左肺动脉远端,1例通过手术取出,另1例任其留存。未观察到死亡病例。这些结果证实了经导管封堵术(TUC)的有效性,发病率低且无死亡,尤其适用于较小的PDA(<4毫米)患者。