经皮穿动脉导管堵塞术的临床应用

１８例动脉导管未闭（ＰＤＡ）患者，年龄７岁～４７岁，平均２３．２±２．６岁，对其采用改进的Ｐｏｒｓｔｍａｎｎ法实施经皮穿刺堵塞术。以彩色多普勒，气囊导管探测未闭导管的大小，结合导管卡尺测量塞子并实施堵塞术。１４例关闭成功，其血流动力学各参数均明显改善或恢复正常。随访１年～７年无栓子移位或再分流发生。在未闭导管关闭后约３０ｍｉｎ时易出现心动过缓，血压下降甚至发生休克。早期处理可避免这一并发症。此方法易于确定未闭导管的实际内径，可避免单凭造影测量的误差，疗效可靠。失败４例:１例未闭导管呈反漏斗型，１例塞子过小，脱入肺动脉，经送至股静脉并切开取出；另２例系股动脉太细而不能送入选定的塞子。１例因压迫过度发生股动脉血栓，经手术去除。     

经皮穿刺动脉导管闭合术的临床应用及并发症的处理

采用改进的Porstmann法对8例动脉导管未闭（PDA）患者实施经皮穿刺堵塞术。以彩色多普勒，球囊导管探测PDA大小，结合导管尺测量塞子并实施堵塞术。6例关闭成功，其血流动力学各参数均明显改善或恢复正常。随访2～4年无栓子移位或再分流发生。失败2例：1例未闭导管呈反漏斗型，塞子脱入肺动脉，经送至股静脉并切开取出；另1例系股动脉太细而不能送入选定的塞子。因此，严格选择适应证是手术成功的关键。     

动脉导管未闭堵塞术的并发症及处理经验

动脉导管未闭堵塞术的并发症及处理经验上海第二医科大学长海医院（２０００２５）秦永文１９６６年Ｐｏｒｓｔｍａｎｎ首先开展经心导管用泡沫塑料塞子堵塞未闭的动脉导管（ＰＤＡ）。此后，Ｒａｓｈｋｉｎ和Ｓｉｄｅｒｉｓ先后发明了双面伞状和扭扣式补片，经静脉途径堵...     

先天性动脉导管未闭介入治疗

先天性动脉导管未闭（ＰＤＡ）在临床应用较广的主要有Ｐｏｒｓｔｍａｎｎ泡沫塞子堵塞术、Ｒａｓｈｋｉｎｄ双面伞闭合术和Ｓｉｄｅｒｉｓ钮扣装置关闭术。我院自１９８８年１月至１９９８年５月用Ｐｏｒｓｔｍａｎｎ法和Ｓｉｄｅｒｉｓ法经导管关闭ＰＤＡ共１８０例,均...     

经导管关闭先天性心脏病动脉导管未闭,房间隔和室间隔缺损的进展

经导管关闭先天性心脏病动脉导管未闭、房间隔和室间隔缺损的进展广东省心血管病研究所王慧深，李渝芬自１９６７年Ｐｏｒｓｔｍａｎｎ等［１］用导管法经股动脉置入塞子，成功堵闭第１例未闭动脉导管（ＰＤＡ）后，介入性心导管术治疗先天性心脏病缺损的研究成为非开胸法...     

经导管Rashkind双伞闭合器关闭动脉导管未闭

应用经导管Ｒａｓｈｋｉｎｄ双伞闭合器半闭５例先天性动脉导管未闭（ＰＤＡ）患者，１例杂音即刻消失，主动脉造影未见分流，４例术后心脏杂音明显减轻，主动脉造影及彩色多普勒血流显像示ＰＤＡ处有微量残余分流，其中２例术后２个月复查杂音消失，超声多普勒检查证实无残余分流。经导管Ｒａｓｈｋｉｎｄ闭合器闭合ＰＤＡ是一种简单、安全、有效的方法。     

堵塞动脉导管未闭时塞子脱落的处理经验

应用泡沫塑料堵塞动脉导管未闭(PDA),已被认为可在临床推广的新技术,但塞子在术中脱落是众所关切的问题。我院有2例在堵塞过程中塞子脱入肺动脉。现将我们取出塞子的经验介绍如下: 我院自1990年至1991年8月,共堵塞动脉导臂未闭12例,其中2例在堵塞过程中塞子脱入肺动脉。     

栓塞术根治动脉导管未闭三次手术后再通病例

栓塞术根治动脉导管未闭三次手术后再通病例任森根，张伟华，康　康患者女性，４４岁。因先天性动脉导管未闭（ＰＤＡ）３次开胸结扎后再通，于１９９４年６月６日入院。第１次１９７０年３月３日在兰州手术，导管粗１２ｍｍ，长６ｍｍ。术后声音嘶哑，２周导管再通。第２...     

经导管堵塞婴幼儿动脉导管未闭89例体会

目的探讨经导管堵塞婴儿动脉导管未闭的疗效。方法对８９例动脉导管未闭患儿采用了４种不同堵塞装置治疗。结果总成功率９８．８８％（８８／８９），失败１例，严重并发症２例，术后２４小时内残余分流１９例（２１．３％），经１个月～３．５年随访，微量残余分流７流（７．０８％）。结论经心导管堵婴幼儿动脉导未闭安全、有效、操作简单、适应证广，可作为治疗婴幼儿动脉导管未闭的首选方法。     

动脉导管内人工栓子脱落的外科治疗

动脉导管内人工栓子脱落临床罕见,近年来,随着先天性心脏病介入治疗的快速发展,此类病例有所增多。１９９８年１月～９月我院先后治疗２例此类病人,现报告如下。１　临床资料　　例１,男性,２０岁。诊断：先天性心脏病——动脉导管未闭,于１９９８年１月２４日行动脉导管堵塞术,弹簧栓子脱落至右上肺动脉,紧急手术,左侧开胸结扎动脉导管;右侧开胸,切开肺动脉,取出弹簧圈。术后９天痊愈出院。　　例２,男性,１８岁。诊断：先天性心脏病——动脉导管未闭,１９９８年９月１６日行动脉导管堵塞术,弹簧栓子脱落至左肺动脉,紧急…     

PDA系统及腕带使用的应用效果及相关分析

在实施＂军字1号＂工程中,我院自2009年实施了＂护士工作站＂系统。提高了护士处理医嘱的工作效率,规范了护理文书,佩戴腕带是在医疗工作中的重要部分,也是对患者实施保护性措施的重要手段,通过PDA对腕带扫码可确定患者身份，     

Anomalous Left Coronary Artery from the Pulmonary Artery in a Preterm Infant: Presentation after Ligation of Ductus Arteriosus

Surgical or medical closure of a patent ductus arteriosus (PDA) is a very common practice in premature infants in the neonatal intensive care unit, but often the coronary arteries are not delineated prior to closure. In this report, a 32‐week gestational age premature infant who underwent surgical ligation of a PDA developed new‐onset left ventricular systolic dysfunction. A repeat echocardiogram noted an anomalous left coronary artery from the pulmonary artery. Successful left coronary artery reimplantation with rapid normalization of left ventricular systolic function occurred. As previously not reported, ligation of a PDA in a premature infant can unmask anomalous left coronary artery from the pulmonary artery. Surgical left coronary artery reimplantation is the mainstay of therapy and should be performed to establish normal coronary blood flow, even in a premature, low birth weight infant.     

Transcathater percutaneous device closure of a large PDA closed in a 3 kg infant

Patent ductus arteriosus (PDA) is common congenital heart disease which may require treatment as transcatheter percutaneous device closure (PDA device closure) or surgical ligation in symptomatic full-term patients. Surgical ligation is an invasive procedure and has more complications especially in the neonates. Problems in PDA device closure are difficult vascular access, manipulation of catheters and sheath, residual shunts, residual obstruction of major arteries etc and these complications increase in low birth weight babies, but it is a less invasive procedure and has fewer complications than surgery, so should be tried in low birth weight patients also. We are presenting a case of 3 kg infant with large PDA (8 mm) presented with failure to thrive, lower respiratory tract infection and heart failure. He successfully underwent PDA device closure with 10 × 12 mm Cocoon PDA device. To the best of our knowledge, this is the first case of the use of such a large device in a 3 kg child with good results.     

经导管法栓塞未闭动脉导管

21例动脉导管未闭(PDA)患者采用经皮导管栓塞术。年龄9～28岁(平均14.69岁)。男性8例,女性13例。用Ivalon塞子栓塞PDA。其中1例手术,20例1次栓塞成功。本文提出PDA栓塞的适应证、并发症和操作经验,证明能够治愈有选择的患者。     

The Role of Multiplane Transesophageal Echocardiography in Diagnosing PDA in an Adult

The usefulness of multiplane transesophageal echocardiography in diagnosing PDA in asymptomatic adults is described.     

Percutaneous closure of the patent ductus arteriosus: opportunities moving forward

The optimal treatment method for infants with a patent ductus arteriosus (PDA) necessitating closure remains a subject of controversy and debate. While the risks associated with surgical PDA ligation are well described, the available evidence base for alternative management strategies during infancy, including percutaneous closure or conservative (nonintervention) management, are not well explored. Among infants, the goals of this review are to: (a) use rigorous systematic review methodology to assess the quality and quantity of published reports on percutaneous closure vs surgical ligation; (b) compare outcomes of percutaneous closure vs conservative management; and (c) based on recommendations from the International PDA symposium, to elucidate needs and opportunities for future research and interdisciplinary collaboration. The available evidence base, as well as on broad consensus reached at the International PDA Symposium, suggests that a contemporary, pragmatic clinical trial comparing PDA treatment strategies is warranted. Additionally, quality assurance safeguards are necessary in the implementation of newer PDA closure devices. Finally, to determine best approaches to treatment for infants with PDA, tools for consistent data collection and reporting across centers and disciplines are needed to minimize heterogeneity and permit pooled analysis.     

Transcatheter closure of long tubular patent arterial ducts: The Amplatzer Duct Occluder II—A new and valuable tool

Despite the wide variety of occlusion devices available for closing the patent ductus arteriosus; some defects with unusual morphology still remain a challenge. The drive for increasingly user friendly and lower caliber delivery systems is also ongoing. The new amplatzer ductal occluder II may prove to be a useful additional tool in these circumstances. We describe our initial experiences with this new device in three patients with long tubular (Type C) ducts. © 2009 Wiley‐Liss, Inc.