Amplatzer封堵器介入治疗动脉导管未闭疗效分析

目的 评价Amplatzer封堵器介入治疗动脉导管未闭(PDA)的临床疗效。方法 对10例管型PDA患儿用Amplatzer PDA封堵器进行堵闭,2例窗型PDA用Amplatzer房间隔双伞封堵器堵闭。在透视下经6F输送器置入封堵器,术后10分钟,行右心导管检查及主动脉弓降部造影,术后24小时、1、3个月分别行彩色多普勒超声心动图、血常规及肝肾功能检查,评价治疗效果。结果 本组技术成功率为100％,患儿心脏双期连续性杂音均消失,术后10分钟主动脉弓降部造影显示少量残余分流2例,均为窗型PDA。术后24小时超声心动图示上述2例仍有微量分流。术后24小时、1、3个月行彩色多普勒超声心动图检查,均未发现残余分流、PDA再通及封堵器移位,血常规及肝肾功能检查均正常。2例有分流的患儿术后均出现急性溶血,经积极内科治疗后好转。其余10例无并发症发生。结论 应用Amplatzer封堵器介入治疗PDA安全有效,近中期疗效满意,远期疗效尚待进一步观察。对窗型PDA可试用Amplatzer房间隔封堵器堵闭。对术后发生急性溶血者可采用内科治疗。

The effect of transcatheler closure of patent ductus arteriosus using Amplatzer occluder device

Objective To evaluate the efficiency and immediate results of transcatheter closure of patent ductus arteriosus (PDA) using Amplatzer occluder device.Methods There were 12 patients with PDA.10 cases were occluded by using Amplatzer duct occluder device through the percutaneous procedure.2 cases of large PDA were occluded by using Amplatzer septal occluder device.The closure procedure was guided by fluoroscopy.Aortographies were made to evaluate the efficiency 10 minutes after the procedure.Echocadiographies were performed 24 hours,1 month and 3 months after the closure to find whether there was residual shunt or recanalization.Results The technique successful rate was 100%.The murmurs of all patients were disappeard.Aortographies revealed residual shunt in 2 cases which had large PDA.Echocadiographies performed 24 hours later also found residual shunt in the same two cases.While 1 month and 3 months after the procedure echocadiographies didn't find any residual shunt or recanalization.Conclusion Transcatheter closure of PDA using Amplatzer occluder device is a safe and efficient method,which has a high successful rate.