经导管Amplatzer堵塞器治疗动脉导管未闭的评价

为研究评价新的自膨性Ａｍｐｌａｔｚｅｒ堵塞器关闭动脉导管未闭（ＰＤＡ）的疗效，于１９９８年８月至１９９９年２月应用Ａｍｐｌａｔｚｅｒ堵塞器关闭突兀 ，年龄０．８～１１岁（平均３．９岁），体重７～３９ｋｇ（平均１５．８ｋｇ），ＰＤＡ最狭处直径２．３～６．４３ｍｍ（平均３．５ｍｍ）。应用６Ｆ长鞘经股静脉插至降主动脉递送堵塞器，术后１０～１５分钟作主动脉造影评价即职效。关闭术后２４小时、１月、３月、６月

Assessment for transcatheter closure of patent ductus arteriosus using a new Amplatzer duct occluder

The aim of the present study was to assess the effect for the catheter closure of patent ductus artenosus (PDA) using a new self-expandable device, Amplatzer duct occluder (ADO). Twenty-six female and 6 male children accepted the transcatheter closure of PDA using the new device at a mean age of 3. 9 years old (ranged 0. 6-11) and weight of 15. 8kg (ranged 7--39kg). The average of PDA diameter at its narrowest segment was 3. 5 mm (ranged 2- 3-6. 43mm). A 6F long sheath was used for delivery of the ADO. At 10-15 minutes after the release, a descending aortogram was performed to assess the immediate results. Follow-up evaluation for the main pulmonary artery with color flow mapping was at 24 hours, 1, 3 and 6 months after closure, respectively. The results showed that all 32 cases succeeded for the device placement. The angiography confirmed that patent ductus arteriosus in 30 patients had been closed completely and only 2 cases remained a small residual shunt. One of two cases had complete closure within 24 hours and another did at one month confirmed by color Doppler. The mean time of the procedure was 42. 5 minutes and of the fluoroscopy was 6. Iminutes. No any complications were found. It is suggested that the new ADO is simple, safe and few complications for the catheter closure of the moderate or large sized PDA. However, further clinical trials and follow-up evaluation will be required.