应用Amplatzer封堵器治疗动脉导管未闭  

Transcatheter closure of patent ductus arteriosus with Amplatzer occluder

作　　者：李志忠[1] 韩玲[1] 金梅[1] 吴邦骏[1] 

机构地区：[1]首都医科大学附属北京安贞医院北京市心肺血管病研究所,100029

出　　处：《中华心血管病杂志》2000年第5期371-373,共3页Chinese Journal of Cardiology

摘　　要：目的　采用Amplatzer封堵器经皮穿刺静脉治疗动脉导管未闭 ,并对其疗效、安全性及并发症进行评价。方法　 31例患者 ,年龄 0 8～ 38 0 (8 1± 6 0 )岁 ,体重 7 0～ 6 9 5 (2 7 7± 2 0 2 )kg。经静脉使用 6F传送器置入Amplatzer堵闭器 ,听诊无杂音后 10min行胸主动脉造影。术前、术后均行血流动力学测定 ,术后 2 4h、3个月、6个月行超声心动图及X线平片检查。结果　全组技术成功率10 0 %。术后即刻所有患者心前区双期连续性杂音消失 ,10min后胸主动脉造影示 2 9例完全堵闭(93 5 % ) ,仅 2例存在极少量残余分流 ,且 48h后超声心动图示该分流消失。动脉导管最窄径 1 5～8 2 (4 4± 1 7)mm ,透视时间 3 0～ 14 5 (6 7± 2 3)min。除 1例患者术后短暂胸部不适外均无任何并发症。随访 3～ 17(9 3± 3 7)个月未发生装置移位、再通或肺动脉狭窄。结论　应用Amplatzer方法经导管治疗动脉导管未闭安全简便 ,创伤小 ,适应证广 ,成功率高 ,疗效可靠 ,可用于新生儿 ,是目前治疗动脉导管未闭最理想的方法。Objective To evaluate the efficiency, safety and complications in the application of Amplatzer occluder for transcatheter closure of patent ductus arteriosus (PDA). Methods Thirty one patients with mean age of 0 8-38 0 (8 1±6 0) years and body weight of 7 0-69 5 (27 7±20 2) kg underwent transcatheter closure of PDA with Amplatzer occluder led by 6F delivery system. Ten minutes after the procedure, aortography was performed to ascertain the efficiency. Hemodynamics was studied before and after the procedure. Echocardiography and X ray was performed 24 hours, 3 months and 6 months after the procedure. Results The success rate was 100%, no continuous murmur was heard in all patients instantly after the procedure. Aortography showed that the lesions were closed completely in 29 cases (93 5%), only a little residual shunt remained in two cases 10 minutes after the procedure. Echocardiogram revealed that the residual shunt disappeared 48 hours later. The mean narrowest diameter of PDA was 1 5-8 2 (4 4±1 7) mm, the mean fluoroscopy time was 3 0-14 5 (6 7±2 3) minutes. No complication was found in all patients except one who felt transient discomfort. In a follow up of 3-17 (9 3±3 7) months, no device displacement, recanalization and pulmonary stenosis appeared. Conclusion Transcatheter closure of PDA using Amplatzer occluder device is safe, efficient and can be used in neonates. The success rate is high, indication is wide, and trauma is little. It is the most ideal procedure in the treatment of PDA at present.

关 键 词：动脉导管未闭 心脏导管插入术 AMPLATZER封堵器 

分 类 号：R654.2[医药卫生—外科学]