经导管封堵婴幼儿动脉导管未闭的疗效观察

目的 :评价经静脉途径用 Amplatzer和自行研制的动脉导管未闭 (PDA )封堵器封堵婴幼儿 PDA的可行性和疗效。方法 :2 1例患儿 ,年龄 1.1～ 6 .0 (3.8± 1.6 )岁 ,体质量 9～ 30 (18.4± 8.2 ) kg,均经临床和心脏超声诊断为 PDA。全麻下经股静脉插入 6～ 8F输送鞘管 ,导入 Am platzer(6例 )或自行研制的 PDA封堵器 (15例 ) ,术前、术后测定肺动脉压力 ,术后 3d复查心脏超声。 结果 :2 1例患儿 ,PDA呈漏斗状 15例、管型 6例 ,PDA最窄径 2～ 12 (6 .7± 3.5 ) mm ,选用的封堵器直径为 6～16 m m,全部患儿均通过股静脉途径一次封堵成功。术后即刻心脏听诊杂音消失 ,肺动脉压均有不同程度下降。结论 :经股静脉途径应用 Amplatzer和自制的 PDA封堵器都能安全地封堵婴幼儿各种类型 PDA,成功率高 ,对动脉的损伤小 ,疗效可靠

Transcatheter closure of patent ductus arteriosus in infants

Objective: To evaluate the safety and efficacy of transcatheter closure of patent ductus arteriosus(PDA) in infants using Amplatzer and self designed ductal occluder.Methods: Twenty one patients aged from 1.1 to 6 years old were included.The diagnosis was made by clinical physical examination and two dimensional echocardiogram.The occlusions were achieved via the antegrade venous approach under general anesthesia.The devices were delivered via 6 F to 8 F catheters.The pulmonary pressures were measured before and after the operation and the echocardiogram were performed 3 d later.Results: The PDA measured from 2 to 12 mm at the narrowest diameter.The diameter of occluder used was from 6 to 16 mm.Amplatzer ductal occluders were implanted in 6 patients,and others were implanted with our self designed dutal occluder.All patients achieved complete occlusion confirmed by angiography immediately or color Doppler 3 d later.The self designed occluder had same efficacy and safety compared with Amplatzer occluder.No complications occurred in all patients.Conclusion: Amplatzer and self designed ductal occluder are safe and highly succesful in infants with PDA.The self designed occluder is much cheaper than that of Amplatzer.