Chee A K, Heng J T, Wong K Y
Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Singapore Med J. 1998 Feb;39(2):64-8.
To report our experience with transcatheter PDA closure using detachable spring coils.
Suitable patients who presented between March 1996 to July 1997 were selected for coil occlusion of PDA after the diagnosis is confirmed on colour doppler echocardiography. Twenty-seven patients underwent an attempt at transcatheter closure of PDA with coils. Twenty-one were native ducts while 6 were residual ductal leaks following surgical ligation (4) and Rashkind umbrella occlusion (2).
The patients' age ranged from 20 months to 39 years (median 5.5 years) and weighed from 10.5 kg to 49 kg (median 21 kg). The PDA diameter ranged from 1.3 mm to 5 mm (mean 2.4 mm). Twenty-four patients had coils successfully deployed (one coil in each patient) and all had PDA diameter of < or = 3.5 mm. Seventeen had complete occlusion on echocardiographic colour doppler assessment within 24 hrs. Follow-up colour doppler assessment showed complete occlusion in all 24 patients by 6 months. There were no cases of coil embolisation or any other complications. Unsuccessful coil deployment was encountered in 3 patients with PDA diameter of > or = 4 mm.
The detachable coil system allows for complete control over coil release and therefore deployment is precise and complications are minimised. Transcatheter closure of PDA with the detachable coil is a safe and effective method especially for small ducts (< or = 3.5 mm).
报告我们使用可脱卸弹簧圈经导管封堵动脉导管未闭（PDA）的经验。
选取1996年3月至1997年7月间确诊的适合患者，在经彩色多普勒超声心动图确诊后，采用弹簧圈封堵PDA。27例患者尝试经导管用弹簧圈封堵PDA。其中21例为原发导管未闭，6例为外科结扎（4例）和Rashkind伞封堵（2例）后残留导管分流。
患者年龄从20个月至39岁（中位年龄5.5岁），体重从10.5 kg至49 kg（中位体重21 kg）。PDA直径从1.3 mm至5 mm（平均2.4 mm）。24例患者弹簧圈成功置入（每位患者置入1个弹簧圈），且所有患者PDA直径≤3.5 mm。17例在24小时内经超声心动图彩色多普勒评估显示完全封堵。随访彩色多普勒评估显示，所有24例患者在6个月时均完全封堵。无弹簧圈栓塞或其他并发症发生。3例PDA直径≥4 mm的患者弹簧圈置入失败。
可脱卸弹簧圈系统可完全控制弹簧圈释放，因此置入精确，并发症最少。经导管用可脱卸弹簧圈封堵PDA是一种安全有效的方法，尤其适用于小导管（≤3.5 mm）。
