超声引导下股动脉途径封堵肥胖青少年动脉导管未闭的疗效观察

目的探讨经食管超声心动图(transesophageal echocardiography,TEE)引导下股动脉途径封堵治疗动脉导管未闭(patent ductus arteriosus,PDA)的安全性与有效性。方法纳入2018年1月至2019年6月在大连市儿童医院心外科行TEE引导下股动脉途径封堵PDA治疗的21例患者,其中男13例、女8例,年龄12.8~17.3(15.1±1.7)岁,体重51.0~89.0(73.4±10.1)kg。评价手术疗效。结果全组患者手术顺利,无改放射线引导或中转开胸病例。平均手术时间(23.9±6.8)min,术后平均住院时间(3.8±0.6)d。无外周血管损伤、心内感染或心包积液等并发症发生。平均随访(19.5±4.9)个月,各项复查结果良好。结论对于一些肥胖、肺气肿、胸廓畸形的PDA患儿,TEE可避免胸壁和肺气等因素的干扰,是一种值得推广的有效补充引导手段。

Efficacy of percutaneous intervention for patent ductus arteriosus guided by transesophageal echocardiography in obese teenagers

Objective To explore the safety and efficacy of transesophageal echocardiography(TEE)-guided percutaneous intervention for patent ductus arteriosus(PDA)in obese teenagers.Methods From January 2018 to June 2019,21 obese teenagers with PDA treated with femoral artery occlusion guided by TEE in the Department of Cardiac Surgery,Dalian Children's Hospital of Dalian Medical University were included in this study,including 13 males and 8 females aged 12.8-17.3(15.1±1.7)years,with an average weight of 51.0-89.0(73.4±10.1)kg.The operative effect was evaluated.Results All patients successfully received the surgery,and none was changed to radiation-guided or thoracotomy ligation.The average operating time was 23.9±6.8 min,the average postoperative hospitalization time was 3.8±0.6 d.No peripheral vascular injury,intracardiac infection or pericardial effusion occurred.The mean follow-up time was 19.5±4.9 months,and the results of all reexaminations were good.Conclusion For some PDA children with obesity,emphysema or thoracic malformation,it is difficult to block PDA by transthoracic ultrasound-guided percutaneous intervention,and TEE can avoid the interference of chest wall and lung qi,or other factors.It is an effective supplementary guidance method worthy of promotion.