Tometzki A J, Arnold R, Peart I, Sreeram N, Abdulhamed J M, Godman M J, Patel R G, Kitchiner D J, Bu'Lock F A, Walsh K P
Royal Liverpool Children's Hospital.
Heart. 1996 Dec;76(6):531-5. doi: 10.1136/hrt.76.6.531.
To report initial experience with a new occlusion device for native and residual patent ductus arteriosus.
Descriptive study of consecutive non-randomised patients undergoing a new method of patent ductus arteriosus closure with detachable coils.
Tertiary centres for paediatric cardiology.
71 consecutive patients, aged 1.2-22 years, with a patent ductus arteriosus (PDA) underwent elective transcatheter closure. 45 had native PDAs (group A) with a minimum diameter of 1.0 mm-5.0 mm (median 2.0 mm). A further 26 had undergone one or more previous occlusion attempts (group B).
A total of 133 detachable (Cook) spring coils were successfully implanted in 70 patients. The procedure was performed transvenously in 51 patients, retrograde arterially in 13, and by both routes in a further 6 patients. One 5 mm coil migrated but was successfully retrieved.
In group A colour flow Doppler echocardiography showed that complete occlusion was achieved in 40/45 (89%) at 24 hours, 41/45 (91%) at 1 month, and 44/45 (98%) by 6 months post procedure. Occlusion rates in residual PDAs were 22/25 (88%) occluded at 24 hours, 23/25 (92%) at 1 month, and 24/25 (96%) at 6 months follow up.
Transcatheter occlusion using detachable (Cook) spring coils is a safe and effective alternative to presently available devices. The delivery system allows full retrieval of the coil until a satisfactory position is obtained.
报告使用一种新型封堵装置治疗先天性及残余动脉导管未闭的初步经验。
对连续接受采用可脱卸线圈封堵动脉导管未闭新方法的非随机患者进行描述性研究。
儿科心脏病学三级中心。
71例连续患者，年龄1.2 - 22岁，患有动脉导管未闭（PDA），接受了择期经导管封堵术。45例为先天性PDA（A组），最小直径1.0 mm - 5.0 mm（中位数2.0 mm）。另外26例曾接受过一次或多次封堵尝试（B组）。
共133个可脱卸（库克公司）弹簧圈成功植入70例患者体内。51例患者经静脉途径进行该操作，13例经逆行动脉途径，另有6例通过两种途径进行。一个5 mm的线圈发生移位，但成功取出。
A组彩色多普勒超声心动图显示，术后24小时40/45（89%）实现完全封堵，1个月时41/45（91%），6个月时44/45（98%）。残余PDA的封堵率在术后24小时为22/25（88%），1个月时为23/25（92%），6个月随访时为24/25（96%）。
使用可脱卸（库克公司）弹簧圈进行经导管封堵是目前可用装置的一种安全有效的替代方法。输送系统允许在获得满意位置之前完全收回线圈。
