经导管介入治疗婴幼儿大型动脉导管未闭临床疗效

目的探讨应用导管介入治疗直径≥5mm婴幼儿大型动脉导管未闭（patent ductus arteriosus．PDA）的临床疗效。方法回顾性分析60例大型PDA（直径≥5mm）患儿的临床资料，着重分析手术方法、临床疗效和随访结果。结果56例PDA采用Amplatzer或国产先健动脉导管封堵器．3例采用膜部室间隔缺损封堵器，1例采用肌部室间隔缺损封堵器。封堵成功率为98．3％（59／60），术后1d超声心动图显示15％（9／60）微量至少量残余分流，术后3月超声心动图复查未见残余分流：3例采用室间隔缺损封堵器患儿术后12月超声心动图示左肺动脉血流速度增快。结论应用导管介入治疗直径≥5mm婴幼儿大型PDA是安全、有效的方法。

Clinical effect of large patent ductus arteriosus in infants treated with transcatheter closure

Objectives To explore the clinical effect of large patent ductus arteriosus （PDA） in infants after the interventional occlusion. Methods We retrospectively analyzed the clinical data of the sixty infants who were with PDA measuring ≥ 5 mm, focused on the operation method, therapeutic results and follow-up results. Results Fifty- six Amplatzer ductal occluders or homemade ductal occluders were used, three membrane ventriculad septal defect devices and one muscular ventricularl septal defect device were also used. The transcatheter closure was conducted successfully in 59 patients with successful rate was 98.3% （59/60）. Echocardiographic monitoring of device position, residual flows, and turbulence in aorta and left pulmonary artery was done at 24 hours, at l month, 3 months, 6 months and 12 months after occlusion. At 24 hours after occlusion, nine patients had trivial to mild residual and after three months, there were no residual flows. There were left pulmonary artery gradients in three patients at 12 months. Conclusions Transcatheter closure of large patent ductus arteriosus in infants is safe and feasible.