应用国产Amplatzer封堵器治疗动脉导管未
闭26例疗效观察
作者：谢皓空，杨铭，段顺元，蒋玉华，刘新中，李建平
【摘要】 目的 评价国产Amplatzer封堵器经导管治疗动脉导管未闭即刻和近期疗效。方法 全组经导管堵闭PDA26例,男9例,女17例,年龄(3～54)岁,体重(8～72)kｇ。均经超声心动图确诊。5Ｆ、6Ｆ或7Ｆ置入Amplatzer封堵器。术后10min行左侧位降主动脉造影，术后24～72h、1周、1个月、6个月行超声心动图检查观察封堵效果及有无并发症。结果 全组技术成功率100%。术后即刻所有患者胸骨左缘第二肋间连续性杂音消失,10min后行左侧位降主动脉造影示24例完全堵闭(92.3%), 2例存在极少量残余分流,但无溶血。且48h后超声心动图示该分流消失。动脉导管最狭窄处直径为2.9～12.0mm。术后1周、1个月、6个月行超声心动图检查无残余分流及动脉导管未闭再通。结论 应用国产Amplatzer封堵器治疗PDA是一种安全、微创的介入性治疗方法,近期疗效可靠,成功率高,操作简便，是目前治疗动脉导管未闭最理想的方法。
【关键词】 Amplatzer封堵器；动脉导管未闭
【Abstract】 Objective To evaluate the immediate and short-term results to transcatheter closure of patent ductus
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arteriosus(PDA) using Amplatzer duct Twenty-six
occluder(ADO)device.Methods
patients(9males,17females,and 3～54years,and body weigth of 8～72kg) were treatedby transcatheter closure with ADO patients were diangnoesd with echocardiography. Long sheaths of 5 to 7 French size were used to translatethe occluders. Follow-up evaluationg were performedwith echocardiogram at 24～72 hours , 1 week and 1～6 months after implantation of the device.Results The success rate was 100%, no continuous murmur was heard in all patients instantly after the proeedure. 10 minutes after the procedure. Aortographies shwed that the patent ductus were closed completely in 24cases(92.3%). only two cases remained a little residual shunt.Echocardiography revealed that rescidual shunt disappeared 48 hours later. The mean narrow est diameter of PDA was 2.9～12.0mm.Conclusion Anterograde transcatheter closure using the ADO is a safe and effective interventional therapy for patients with PDA .It has a high technical success rate and satisfactory immediate and short term results, it is a ideal procedure in the treatment of PDA
【Key words】 Amplatzer occluder; patent ductus arteriosus
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动脉导管未闭(Ｐａｔｅｎｔｄｕｃｔｕｓａｒｔｅｒｉｏｓｕｓ,PDA)是常见的先天性心脏病,以往的根治方法为传统外科开胸手术。但开胸手术有损伤大,恢复慢等缺陷。Amplatzer封堵器是一种新型的PDA封堵器,我院自2004年应用国产Amplatzer封堵器(深圳先健公司)治疗动脉导管未闭26例,取得了满意的临床效果。现报告如下。
1 资料与方法
1．1 一般资料
全组经导管堵闭PDA 26例,男9例,女17 例, 年龄(3～54)岁,体重(8～72)kｇ。体检发现胸骨左 缘 第二肋间有连续性杂音,均经临床、心电图、Ｘ线胸片、超声心动图确诊为单纯PDA。降主动脉造影证实PDA漏斗型15例,管型8例,类似窗型3例。术前肺动脉压(45.2±18.6）mmＨｇ。
1．2 国产Amplatzer封堵器选择
由深圳先健公司制造,整套系统由蘑菇伞器、输送钢丝、导入短鞘、输送长鞘组成。蘑菇伞器由具有自膨胀性的单盘及连接单盘的
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应用国产Amplatzer封堵器治疗动脉导管未闭26例疗效观察
