应用Amplatzer封堵器治疗动脉导管未闭疗效评价.doc

应用Amplatzer封堵器治疗动脉导管未闭疗效评价 　　　【摘要】　目的　应用Amplatzer封堵器经导管治疗动脉导管未闭并对其疗效进行评价。方法　全组33例，平均年龄18.2±14.0(0.8～51)岁，平均体重36.2±16.9(6.4～70)kg。动脉导管未闭最窄处直径为4.9±2.1(2.9～10.0)mm。经6或7 F导管置入Amplatzer封堵器，术后10 min行侧位降主动脉造影观察有无分流。术后1天、1个月、6个月及1年行超声心动图检查观察有无残余分流及动脉导管未闭再通。结果　一次封堵成功者32例，二次封堵成功者1例，无任何并发症发生。术后10 min降主动脉造影示8例有微-少量残余分流。术后24 h超声心动图均无残余分流。随访1～12个月，均未发现有残余分流。结论　应用Amplatzer封堵器治疗直径达10 mm的动脉导管未闭是一种安全有效的介入方法，操作简便，成功率高，疗效可靠。 　　Transcatheter closure of patent ductus arteriosus using 　　the Amplatzer duct occluder: preliminary results 　　【Abstract】　Objective　To evaluate the safety and efficiency of anterograde catheter closure of patent ductus arteriosus (PDA) using the Amplatzer duct occluder (ADO) device. Methods　33 patients (5 male, 28 female) underwent attempted transcatheter closure of PDA using the ADO at a median age of 18.2±14.0 years (range 0.8 to 51) and a median weight of (36.2±16.9)kg (range 6.4 to 70). The mean PDA diameter at its narrowest segment was (4.9±2.1)mm (rang 2.9 to 10). A 6F or 7F long sheath was used for delivery of the ADO. The lateral descending aortographies were performed to evaluate the immediate results 10 minu tes after the procedure. Echocardiographies were performed 1 day, 1 month, 6 months and 1 year after the closure to find whether there was residual shunt and recanalization. Results　32 of the 33 patients had successful device placement at the first time. One patient had successful device placement at the second time. There were no complications. Angiography showed that 23 patients had complete immediate closure, 8 had a trace to small shunt 10 minutes after the procedures. Within 24 h, color doppler revealed complete closure in all patients. No residual shunt and PDA recanlization after the complete closure were found during a-follow-up of 1-12 months. Conclusion　Anterograde transcatheter closure using the ADO is a safe and effective interventional therapy for patients with a PDA diameter up to 10 mm. It had a high successful rate and satisfied imm