室间隔缺损封堵器关闭婴儿大管型动脉导管未闭的初步评价  

Initial experience in transcatheter closure of large patent ductus arteriosus in infants using locally-made symmetrical VSD occluder

作　　者：谢育梅[1] 张智伟[1] 李渝芬[1] 钱明阳[1] 石继军[1] 王树水[1] 

机构地区：[1]广东省心血管病研究所广东省人民医院心儿科,广东广州510080

出　　处：《临床儿科杂志》2009年第6期589-591,共3页Journal of Clinical Pediatrics

基　　金：国家科技支撑计划项目基金资助(No.2007BAI05B03)

摘　　要：目的应用国产室间隔缺损封堵器关闭婴儿大管型动脉导管未闭并对其疗效进行初步评价。方法2007年5月-2008年2月就诊的10例4～9个月婴儿经主动脉造影确诊为大管型动脉导管未闭,最窄处内径为4.1～7.4mm,长度7.9～11.9mm,合并中～重度的肺动脉高压。选用6～12mm国产肌部或膜部室间隔缺损封堵器进行介入治疗,术后主动脉造影、术后24h及1～6个月进行超声心动图随访观察疗效。结果全组技术成功率100%,术后主动脉造影和超声心动图显示无残余分流。随访超声心动图无明显降主动脉缩窄,1例左肺动脉轻度狭窄。无其他不良并发症。结论室间隔缺损封堵器可用于关闭婴儿粗大管型的动脉导管未闭,成功率高,近期疗效肯定,中远期疗效需随访观察。Objective To evaluate the feasibility and efficacy of transeatheter closure of large fistular patent arterial duct （PDA） in infants by using locally-made symmetrical ventricle septal defect （VSD） occluder. Methods Ten patients （seven females and 3 male, mean age of 7.1 months, mean weight of 5.6 kilograms, the lowest weighing 4.5 kilograms） with large PDA （width ranging from 4.1 to 7.4 mm, length from 7.9 to 11.9 ram） underwent percutaneous closure with locally-made symmetrical ventricle septal defect （VSD） occluder between May 2007 and February 2008. The size of occluder ranged from 6 to 12 ram. All patients had significant pulmonary hypertension. The efficacy of the treatment was evaluated with aortic angiography after the procedure, echocardiogram examination 24 hours after procedure and one to six months follow up. Results Closure was achieved in all patients, eight muscular and two membranous VSD oceluders were implanted. All ducts were closed completely, no residual shunting was detected in either aortic angiography or echo- cardiogram examination. All showed excellent clinical improvement in the follow up except one with slight obstruction to the left pulmonary artery. Conclusions Complete closure of large fistular patent arterial ducts is now possible, even in sick and underweight infants using the symmetrical muscular or membranous VSD occluder. Efficacy in shorHerm was confirmed, while medium-term and long-term efficacy should be followed up.

关 键 词：动脉导管未闭 封堵器 经导管关闭 婴儿 

分 类 号：R725.4[医药卫生—儿科]