Galal O, de Moor M, al-Fadley F, Hijazi Z M
Department of Cardiovascular Diseases, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
Am Heart J. 1996 Feb;131(2):368-73. doi: 10.1016/s0002-8703(96)90368-3.
Thirty-five patients (mean age 43.7 months, mean weight 13 kg) underwent anterograde patent ductus arteriosus (PDA) occlusion with Gianturco coils (coil group). These patients were compared with 35 age- and weight-matched patients who underwent closure of their PDA with the Rashkind umbrella device (device group). The mean PDA diameter at its narrowest point was 2.8 mm in the coil group and 2.7 mm in the device group. There was immediate closure angiographically in 20 (57%) of 35 in the coil group compared with 9 (26%) of 35 for the device group. Color flow mapping before discharge revealed complete closure in 30 (86%) of 35 in the coil group compared with 18 (51%) of 35 in the device group (chi square = 9.5455, p < 0.005). Mean fluoroscopy time was 18.5 minutes (median 13.5 minutes) and 14.7 minutes (median 13 minutes) for the coil and device, respectively. Four coils and one device embolized down the pulmonary artery; all were successfully retrieved in the catheterization lab. Coil closure of the small to moderate PDA is safe and effective. It is more effective in achieving immediate closure than the Rashkind device. More clinical trials with the coil technique are warranted to establish the long-term results of this technique.
35例患者（平均年龄43.7个月，平均体重13千克）采用弹簧圈（弹簧圈组）进行动脉导管未闭（PDA）顺行封堵。将这些患者与35例年龄和体重匹配、采用Rashkind封堵伞装置进行PDA封堵的患者（装置组）进行比较。弹簧圈组PDA最窄处的平均直径为2.8毫米，装置组为2.7毫米。弹簧圈组35例中有20例（57%）造影显示立即封堵，而装置组35例中只有9例（26%）。出院前彩色血流图显示，弹簧圈组35例中有30例（86%）完全封堵，装置组35例中有18例（51%）完全封堵（卡方检验=9.5455，p<0.005）。弹簧圈组和装置组的平均透视时间分别为18.5分钟（中位数13.5分钟）和14.7分钟（中位数13分钟）。4个弹簧圈和1个装置栓子进入肺动脉；所有均在导管室成功取出。弹簧圈封堵中小PDA安全有效。与Rashkind装置相比，其在实现立即封堵方面更有效。需要更多关于弹簧圈技术的临床试验来确定该技术的长期效果。
