摘要
目的评价应用Amplatzer ductal occluder(ADOⅡ)封堵器配合微导管微导丝轨道技术介入封堵患儿极细小动脉导管未闭(PDA,术中造影测量直径<1 mm)的安全性及有效性。方法2017年4月10日至2019年12月20日中国医学科学院阜外医院共12例诊断为极细小PDA的患儿采用微导管微导丝轨道技术进行介入封堵治疗。所有患者均经超声心动图、心电图、X线胸片确诊后收住院进行介入封堵治疗,术后进行超声心动图、心电图、X线胸片门诊随访。结果12例患儿中男性4例,女性8例;年龄(3.7±1.5)岁;体重(16.4±5.4)kg。12例患儿PDA造影形态均为长管型,造影测量的PDA最窄处平均直径(0.8±0.1)mm,PDA平均长度(17.1±6.1)mm。12例患儿手术成功率12/12,术后即刻完全封堵率12/12,围术期无严重并发症发生。其中采用穿刺股动脉、股静脉建立全轨道法经股静脉入径顺行封堵1例、经股动脉入径逆行封堵5例,采用穿刺股动脉建立半轨道经股动脉入径逆行封堵6例。所有患者均完成6个月门诊随访,无严重并发症发生。结论应用ADOⅡ封堵器配合微导管微导丝轨道技术封堵儿童极细小PDA作为一种安全、有效的技术值得进一步临床推广。
Objective To evaluate the safety and effi cacy of ADO II combined with micro-catheter and micro-guidewire rail technique in transcatheter closure of very small patent ductus arteriosus(PDA,the diameter measured by fl uoroscopy<1 mm)in children.Methods From April 10,2017 to December 20,2019,12 children with very small PDA were treated with micro-catheter micro-guidewire rail technique in the third ward of the structural Heart Disease Center of Fuwai Hospital.All patients were diagnosed by echocardiography,electrocardiogram,and chest X-ray,and were hospitalized for interventional occlusion.Echocardiography,electrocardiogram,and chest X-ray were used for postoperative follow-up.Results Among the 12 cases,there were 4 males and 8 females,with a mean age of(3.7±1.5)years old,and body weight of(16.4±5.4)kg.The shape of PDA in 12 children was tubule type,and the average diameter of PDA measured by angiography was(0.8±0.1)mm,and the average length was(17.1±6.1)mm.Both the success rate of operation and the rate of immediate occlusion was 12/12.There was no severe complication during the perioperative period.Antegrade(femoral)approach(1 procedure)and retrograde(aortic)approach(5 procedures)were used a full rail.An antegrade(femoral)approach was used in 6 of procedures based on a semi-rail.All patients completed 6-month follow-up and no severe complications occurred.Conclusions ADOⅡcombined with micro-catheter micro-guidewire rail technique to occlude very small PDA in children is a safe and eff ective technique,which is worthy of further clinical promotion.
作者
耿文磊
胡海波
吕建华
刘垚
徐亮
徐仲英
张戈军
潘湘斌
GENG Wen-lei;HU Hai-bo;LV Jian-hua;LIU Yao;XU Liang;XU Zhong-ying;ZHANG Ge-jun;PAN Xiang-bin(Department of Radiology,Chinese Academy of Medical Sciences and Peking Union Medical College,Fuwai Hospital,National Center for Cardiovascular Diseases,Beijing 100037,China)
出处
《中国介入心脏病学杂志》
2021年第4期206-209,共4页
Chinese Journal of Interventional Cardiology
关键词
动脉导管未闭
介入治疗
先天性心脏病
Patent ductus arteriosus
Interventional therapy
Congenital heart diseases
