特殊形态动脉导管未闭的介入治疗

目的探讨特殊形态动脉导管未闭(PDA)的介入治疗方法,评价其临床应用价值。方法7例应用标准型Amplatzer导管封堵器难以完成介入治疗的PDA患者,根据造影显示PDA形态及临床特点,相应选用成角型Amplatzer导管封堵器以及偏心型导管封堵器进行介入治疗,术后以心脏超声随诊评价疗效。结果7例患者皆成功完成介入治疗,无严重并发症发生;其中2例应用成角型Amplatzer导管封堵器,5例应用偏心型导管封堵器;2例经二次手术完成,余患者一次治疗完成。7例患者中,封堵术后即刻造影显示有2例封堵完全,术后24h心脏超声检查示6例封堵完全,术后3个月复查皆封堵完全。结论需要设计和生产不同形态和大小的封堵装置,以扩大PDA介入治疗的适应证。

Transcatheter closure of patent ductus arteriosus with special conformation

Objective To study the method of transcatheter closure of patent ductus arteriosus (PDA) with special conformation and assess the clinical value of the procedure. Methods 7 patients with PDA which failed to be closed by standard Amplatzer duct occluders (ADO) underwent transcatheter closure with different devices according to the angiocardiography conformation and the clinical manifestation. The devices included angled Amplatzer duct occluders and asymmetric duct occluders. All patients were studied by transthoracic color Doppler echocardiography at 24 hours, one, three and six months after the operation. Results Different occluders were successfully implanted in all patients, including 2 angled Amplatzer duct occluders and 5 asymmetric duct occluders. There were no complications happened in all the procedures. 2 patients received 2 closure procedures because of no suitable occluders in hand during the first time while the others completed at one time. Immediate imaging after the procedure showed complete PDA closure in 2 patients. Color Doppler echocardiography showed complete closure in 6 patients after 24 hours, and in all patients after 3 months. Conclusion Transcatheter closure of PDA demands different kinds of devices because of varied angiocardiography conformations. More patients with PDA will benefit from individual approach.