中华儿科杂志
中華兒科雜誌
중화인과잡지
Chinese Journal of Pediatrics
2013年
2期
126-129
,共4页
吉炜%李奋%高伟%余志庆%黄美容%傅立军%郭颖%赵鹏军%刘廷亮%张玉奇%陈轶维
吉煒%李奮%高偉%餘誌慶%黃美容%傅立軍%郭穎%趙鵬軍%劉廷亮%張玉奇%陳軼維
길위%리강%고위%여지경%황미용%부립군%곽영%조붕군%류정량%장옥기%진질유
动脉导管未闭%治疗结果%第二代动脉导管未闭封堵器
動脈導管未閉%治療結果%第二代動脈導管未閉封堵器
동맥도관미폐%치료결과%제이대동맥도관미폐봉도기
Ductus arteriosus,patent%Treatment outcome%Amplatzer duct occluder Ⅱ
目的 探讨应用第2代Amplatzer动脉导管封堵器(ADO-Ⅱ)经导管治疗动脉导管未闭的适应证和方法学,并评价其疗效.方法 经4F或5F递送鞘通过顺向或逆向法置入ADO-Ⅱ封堵器,对51例动脉导管未闭患儿进行介入封堵治疗.术中及术后行超声心动图、降主动脉造影观察封堵器位置、有无分流以及动脉梗阻,随访行经胸超声心动图复查.结果 49例即刻封堵成功,术后即刻及后续随访未出现明显残余分流,左肺动脉及降主动脉无梗阻；1例ADO-Ⅱ释放后即刻发现降主动脉梗阻,经导管取出ADO-Ⅱ并以第1代ADO重新进行封堵后降主动脉梗阻缓解,1例术后1个月心脏超声复查发现左肺动脉严重梗阻,通过外科手术取出封堵器及行左肺动脉成形术后梗阻缓解.结论 新型ADO-Ⅱ封堵器适用于小型非窗型动脉导管未闭的封堵治疗,如适应证及方法学适当,效果良好.
目的 探討應用第2代Amplatzer動脈導管封堵器(ADO-Ⅱ)經導管治療動脈導管未閉的適應證和方法學,併評價其療效.方法 經4F或5F遞送鞘通過順嚮或逆嚮法置入ADO-Ⅱ封堵器,對51例動脈導管未閉患兒進行介入封堵治療.術中及術後行超聲心動圖、降主動脈造影觀察封堵器位置、有無分流以及動脈梗阻,隨訪行經胸超聲心動圖複查.結果 49例即刻封堵成功,術後即刻及後續隨訪未齣現明顯殘餘分流,左肺動脈及降主動脈無梗阻；1例ADO-Ⅱ釋放後即刻髮現降主動脈梗阻,經導管取齣ADO-Ⅱ併以第1代ADO重新進行封堵後降主動脈梗阻緩解,1例術後1箇月心髒超聲複查髮現左肺動脈嚴重梗阻,通過外科手術取齣封堵器及行左肺動脈成形術後梗阻緩解.結論 新型ADO-Ⅱ封堵器適用于小型非窗型動脈導管未閉的封堵治療,如適應證及方法學適噹,效果良好.
목적 탐토응용제2대Amplatzer동맥도관봉도기(ADO-Ⅱ)경도관치료동맥도관미폐적괄응증화방법학,병평개기료효.방법 경4F혹5F체송초통과순향혹역향법치입ADO-Ⅱ봉도기,대51례동맥도관미폐환인진행개입봉도치료.술중급술후행초성심동도、강주동맥조영관찰봉도기위치、유무분류이급동맥경조,수방행경흉초성심동도복사.결과 49례즉각봉도성공,술후즉각급후속수방미출현명현잔여분류,좌폐동맥급강주동맥무경조；1례ADO-Ⅱ석방후즉각발현강주동맥경조,경도관취출ADO-Ⅱ병이제1대ADO중신진행봉도후강주동맥경조완해,1례술후1개월심장초성복사발현좌폐동맥엄중경조,통과외과수술취출봉도기급행좌폐동맥성형술후경조완해.결론 신형ADO-Ⅱ봉도기괄용우소형비창형동맥도관미폐적봉도치료,여괄응증급방법학괄당,효과량호.
Objective To evaluate the indications,methodology and results of the transcatheter closure of patent ductus arteriosus (PDA) with the new Amplatzer Duct Occluder Ⅱ (ADO-Ⅱ).Method Totally 51 patients underwent transcatheter closure of PDA with the new ADO-Ⅱ.The devices were delivered by 4F or 5F sheath through arterial or venous side respectively.The descending aorta angiography and transthoracic echocardiography was performed to evaluate the device position,residual shunt and complications caused by the device during and after implantation.Result Forty-nine patients had successful transcatheter closure of the PDA without significant residual shunts and artery obstruction during the short-term follow-up.One patient received the ADO-Ⅱ dislodgment and first generation ADO reimplantation for the obvious descending aortal obstruction caused by ADO-Ⅱ.Another patient had the ADO-Ⅱ dislodgment and left pulmonary artery shaping surgery,because the ADO-Ⅱ implantation led to obstruction of the left pulmonary artery.Both the obstructions in these two patients were ameliorated afterwards.Conclusion The transcatheter closure using the ADO-Ⅱ is safe and effective for the nonwindow type PDA with a small size.
