摘要
目的分析中老年动脉导管未闭（PDA）患者的临床特征及探讨行经导管封堵治疗的安全性。方法选择2000年1月至2009年4月在我科介入治疗的139例40岁以上PDA患者，男22例，女117例，年龄40～74（49．8±6．8）岁，术前心功能分级为Ⅰ级64例，Ⅱ级53例，Ⅲ级16例，Ⅳ级6例，分析中老年PDA患者临床特征及观察封堵PDA前后肺动脉压和心功能的改善情况。结果139例患者中合并肺动脉高压107例，发生率为77．0％，3例严重肺动脉高压者不适宜手术治疗，其余136例均成功行介入治疗，成功率为97．8％。封堵PDA后主动脉造影显示残余分流微母14例，少量2例，中等量分流1例，无手术相关并发症。术后心功能显著改善，肺动脉收缩压由术前（47．3±23．9）mmHg（1mmHg=0．133kPa）降至（28．1±12．3）mmHg，肺动脉平均压由（31．7±17．4）mmHg降至（17．9±8．8）mmHg（均P〈0．01）。结论中老年PDA患者肺动脉高压发生率高，心功能差，经导管封堵中老年PDA是一种安全有效的方法。
Objective To analyze the clinical feature and the effects of transcatheter closure of adult patients with patent ductus arteriosus （PDA）. Methods Between January 2000 and April 2009, 139 patients [ 22 male, aged from 40 to 74 ： （ 49. 8 ± 6. 8 ） years ] with PDA were hospitalized in our hospital. Clinical data and effects of transcatheter closure of PDA were analyzed. Results There were 64 patients with NYHA class Ⅰ , 53 with class Ⅱ , 16 with class Ⅲ and 6 with class Ⅳ before procedure. In 139 patients, pulmonary arterial hypertension （PAH） was found in 107 out of 139 patients （77.0%）. Transcatheter PDA closure was not performed in 3 patients due to severe PAH and successfully performed in the remaining 136 patients （97.8%） without major complications. Post procedure aortic angiography evidenced minor residual shunt in 14 cases, small residual shunt in 2 cases and moderate shunt in 1 case. The NYHA class was significantly improved and the PAH significantly reduced [ sPAP： （47.3 ± 23.9） mm Hg （ 1 mm Hg = 0. 133 kPa） vs. （28. 1 ± 12. 3） mm Hg,P 〈 0.01 ] post procedure. Conclusion PAH and heart failure were commonly associated with PDA in adult patients. Transeatheter PDA closure is safe and effective in these patients except those with severe PAH.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2009年第11期998-1001,共4页
Chinese Journal of Cardiology
