带阀门内支架在动脉导管未闭介入治疗中的应用  

Transcatheter occlusion of patent ductus arteriosus using stent with valve: the clinical experience

作　　者：王永武[1] 李钦传 冯靖 曹克坚[1] 张维桢 黄国长[1] 

机构地区：[1]上海铁道大学医学院附属甘泉医院胸心外科,200065

出　　处：《中华心血管病杂志》2000年第2期102-104,共3页Chinese Journal of Cardiology

基　　金：国家自然科学基金! ( 3 9870 2 0 9);上海市科学基金!(974119028)

摘　　要：目的　评价带阀门内支架在动脉导管未闭 (PDA)介入治疗中的疗效和安全性。方法　2 2例PDA患者 ,年龄 3～ 5 3岁 ,女性 17例 ,男性 5例。PDA内径 (最狭处 ) 1 4～ 11mm ,平均 5 2mm ;主动脉端内径 (最宽处 ) 2 1～ 12mm ,平均 7 1mm ;PDA长度 2 5～ 19mm ,平均 10 3mm。漏斗型 3例、管型 10例、乳头型 3例、窗型 2例、PDA结扎术后再通 4例。前 10例建立股动脉 PDA 股静脉轨迹 ;后 12例建立股动脉 PDA 肺动脉的导丝半轨迹。根据PDA内径选择血管鞘同时选择不同型号的带阀门内支架PDA堵闭装置。结果　一次堵闭成功 2 1例 ,即刻PDA造影显示无残余分流 ,术后第一天 ,检查X线胸部正侧位片 ,见支架固定良好 ,出院前超声心动图检查无残余分流。随访 2～ 46个月 ,无 1例再通 ,恢复良好。结论　该技术及其装置可靠、有效 ,可堵闭各种类型的PDA ,尤其适用于堵闭婴幼儿和巨大PDA患者。Objective To elucidate the clinical effect of stent with valve on occlusion of the patent ductus arteriosus (PDA). Methods PDA were diagnosed in 22 patients; females and males were 17 and 5 cases, respectively; age ranged from 3 to 53 years old. The types of PDA were divided into funnel type in 3, tubular type in 10, nipple type in 3, window type in 2, and reopen after surgical occlusion in 4. The stent with valve was delivered to PDA by a catheter through femoral artery to close it. Results There were no residual shunts in all patients after the procedure examined by echocardiography and cineangiography. Followed up 2—46 months, all the patients recovered satisfactorily. Conclusion The successfully clinical usage of stent on patients with PDA demonstrates that the stent is reliable, effective and especially suitable to be the large PDA and infant patients.

关 键 词：动脉导管未闭 支架 心脏导管插入术 介入疗法 

分 类 号：R541.1[医药卫生—心血管疾病]