摘要
目的探讨采用国产蘑菇伞型封堵器经导管封堵巨大动脉导管未闭(PDA)的可行性。方法全组15例,其中男3例,女12例,年龄21±8(16～46)岁。PDA最窄处直径为16±3mm(13～22mm),均采用国产蘑菇伞型封堵器经股静脉途径对PDA进行封堵。封堵前后行主动脉弓降部造影并测定肺动脉压力。封堵成功者分别于术后1周、1个月和6个月复查超声心动图。结果15例巨大PDA选用的封堵器直径为23±4mm(18～32mm),封堵后30min主动脉弓降部造影均显示主-肺动脉水平仅有经封堵器孔眼的微量到少量残余分流。封堵后13例患者肺动脉收缩压峰值较封堵前有不同程度下降(70±29mmHgvs113±21mmHg,P<0.05,1mmHg=0.133kPa),2例因试封堵后肺动脉压力升高而放弃封堵。无一例发生严重并发症。封堵成功者术后复查超声心动图,其中11例于术后1周、1例于术后1个月残余分流消失,另1例于术后6个月时残存少量分流。结论采用国产蘑菇伞型封堵器经导管封堵巨大PDA是一种安全有效的介入治疗方法。
Objective To evaluate the safety and efficacy of homemade patent ductus arteriosns （PDA） closure device for patients with very large PDA. Methods A total of 15 patients （ 12 females） with very large PDA, underwent transcatheter occlusion with homemade PDA devices. The median age was 21 ± 8 （ 16 - 46） years old. The median diameter of the PDA at its narrowest point was 16 ± 3 （ 13 - 22） mm. Aortic angiography and measurement of pulmonary pressure were performed before and after the closure of PDA. Repeat echocardiography was performed on each patient at one week, one month and six months after the procedure. Results Fifteen patients underwent transcatheter closure using a device of 23 ± 4 （ 18 - 32）mm in diameter, and all of them showed a trace to small shunt by aortic angiography 30 minutes after the procedure. Thirteen patients was successfully occluded with a peak systolic pulmonary pressure decreased from 113 ± 21 mm Hg to 70 ± 29 mm Hg （P 〈 0.05, 1 mm Hg= 0. 133 kPa）. On the other hand, the device was removed from the remaining 2 patients because the peak systolic pulmonary pressure increased after the closure. No major complications happened in the study. The follow-up echocardiography showed complete PDA occlusion in 12 patients and only 1 patient had a trace shunt at 6 months after transeatheter closure. Conclusion Transcatheter occlusion with homemade PDA closure device is a safe and effective treatment for patients with very large PDA.
出处
《中国介入心脏病学杂志》
2005年第4期225-227,共3页
Chinese Journal of Interventional Cardiology
