应用Amplatzer封堵器介入治疗房间隔缺损和动脉导管未闭

目的：评价用Amplatzer封堵器介入治疗继发孔型房间隔缺损（ASD）与动脉导管未闭（PDA）的疗效与安全性。方法：在X线透视和超声心动图或主动脉弓降部造影指导下，经导管置入Amplatzer封堵器施行ASD封堵术26例，PDA封堵术10例。术结及术后24小时、1个月、3个月分别行超声心动图检查评价疗效。结果：26例ASD患者共27个缺损，22例ASD球囊最大伸展直径12－32mm，4例ASD经食管超声心动图（TEE）测量直径＞34mm，选择Amplatzer封堵器直径为13－38mm。24例25个缺损应用24只Amplatzer封堵器闭合成功，成功率92．3％，10例PDA封堵术均获得成功。主动脉弓降部造影示动脉导管呈漏斗型8型，管型2例，未闭动脉导管最窄处直径为3.5-8.0mm。随访未发现封堵器移位及残余分流。1例PDA在术后4h出现心包积液，经心包穿刺置管引流后次日消失，病人痊愈出院。无其他严重并发症发生。结论：应用Amplatzer封堵器介入治疗ASD操作简便，安全，成功率高。

Transcatheter closure of secundum atrial septal defect and patent ductus arteriosus using Amplatzer occluder device

Objective To evaluate the efficiency and safety of transcatheter closure of secundum atrial septal defect(ASD) and patent ductus arteriosus(PDA) using Amplatzer occluder device. Methods Twenty six patients of ASD and 10 patients of PDA were occluded using Amplatzer occluder device through the percutaneous procedure. The closure procedure was guided by fluoroscopy ,transesophageal echocardiography(TEE) and aortagraphy. TEE was performed immediately and transthoracic echocardiography (TTE) was done at 24 hours , 1 month and 3 months after the procedure,respectively. Results The mean balloon stretched diameter of 22 patients of ASD was 22.0mm(ranged from 12 to 32mm). The diameter by TEE of 4 patients were more than 34mm.The mean diameter of the occluder selected was 27mm (ranged from 13 to 38mm). 24 patients of ASD had successful imptantation of the Amplatzer occluder device, two were not . The saccessfu1 rate of PDA was 100%. The mean narrowest diameter of PDA was 4.6 mm(ranged from3.5 to 8mm).The diameter of the occluder selected was ranged from 6 to12mm. No residual shunt was found in 34 cases. Conclusion Transcatheter closure of secundum ASD and PDA using Amplatzer occluder device is simple, safe, and has a high successful rate.