应用肌部室缺封堵器治疗超大型动脉导管未闭合并重度肺动脉高压的疗效

目的　探讨应用肌部室缺封堵器(AMVSDO)治疗合并肺动脉高压的大型动脉导管未闭(PDA)的效果。方法　1例成人巨大动脉导管未闭(直径17mm)合并重度肺动脉高压(肺动脉压力为117/72mmHg) ,应用Amplatzer肌部室缺封堵器进行封堵,封堵后行降主动脉造影,观察封堵效果。结果　先选用16mmAMVSDO进行封堵,效果不满意,后换用2 0mmAMVSDO ,封堵后即刻肺动脉压力由117/72 (95 )mmHg降为92/ 5 9(75 .5 )mmHg,降主动脉造影显示封堵器位置合适,存在微量渗透性残余分流,释放封堵器。结论　应用Amplatzer肌部室缺伞封堵合并严重肺动脉高压的大型PDA是一种有效可行的治疗方法,但其临床应用的适应证、安全性及远期效果尚待进一步研究

Transcatheter closure of a very large patent ductus arteriosus with severe pulmonary hypertension using amplatzer muscular ventricular septal defect occluder.

Objective To observe the effect of transcatheter closure of large patent ductus arteriosus(PDA) with severe pulmonary hypertension(SPH) using Amplatzer muscular ventricular septal defect occluder(AMVSDO). Methods Transcatheter closure of PDA using AMVSDO was performed in one patient suffering from large PDA with SPH. The immediate effect of occlusion was observed by aortorgraphy. Results 20 mm sized AMVSDO was used after the 16 mm sized one was tried failure, pulmonary pressure decreased from 117/72(95) mmHg to 92/59(75.5) mmHg immediately after occlusion. Aortorgraphy showed that the place of occluder was suitable though little residual shunt leaving.Conclusions Transcatheter closure of large PDA with SPH using AMVSDO was efficacious and feasible. The safety and long-term effect need further observation.