经导管封堵治疗动脉导管未闭(摘要)
作者：王玉林 韩波 刘芳 张建军 韩秀珍 汪冀 马沛然 郭文彬 朱梅
单位：山东省济南市，山东省立医院 儿科(250021) 王玉林 韩 波 刘 芳 张建军 韩秀珍 汪 冀 马沛然；心脏B超室 郭文彬 朱 梅
关键词：
目的 目的：应用Cook弹簧圈及Amplatzer封堵器经导管治疗动脉导管未闭(PDA)患儿并对其进行评价。
方法：根据心脏超声及心血管造影结果选择经股静脉递送Amplatzer或Cook弹簧圈封堵器，一般动脉导管最窄处小于3 mm选用弹簧圈，大于3 mm选用Amplatzer封堵器，术后选择性降主动脉造影及B型超声心动图评价其结果。
结果：5例PDA最窄处直径分别为1.7、1.2、3.1、5.6和8.3 mm,前2例选用Cook公司MWCE-5-PDA5弹簧圈，后3例分别选用4～6 mm、10～12 mm和12～14 mm Amplatzer封堵伞。前4例PDA封堵后即刻杂音消失，主动脉弓降部造影显示无残余分流，2天后超声心动图示心脏大小恢复正常；第5例因导管较粗，压差较大，在用12～14 mm Amplatzer封堵伞的基础上又加用5 mm Cook弹簧圈一个，封堵后仍有少量渗透性残余分流，但复查超声心动图显示心脏较前明显减小。3个月后复查超声心动图残余分流消失。
结论：应用Cook弹簧圈经导管治疗小型动脉导管未闭，Amplatzer封堵器治疗中、大型动脉导管未闭是安全有效的介入方法，操作简单，疗效满意。
Transcatheter Closure of Patent Ductus Arteriosus in Children (Abstract)
Pediatric Department, Shandong Provincial Hospital, Ji′nan (250021), Shandong
Wang Yulin, Han Bo, Liu Fang, et al.
Objective: To evaluate the safty and efficiency of transcatheter closure of patent ductus arteriosus (PDA) using coil or Amplatzer occluder device.
Methods: The narrowest diameter of PDA in five children was 1.7 mm, 1.2 mm, 3.1 mm, 5.6 mm and 8.3 mm, respectively. Cook coil was choosed if the PDA was smaller than 3 mm and Amplatzer was selected if the PDA was larger than 3 mm. Aortographies were performed immediately after the procedure to evaluate the efficiency.
Results: Cook MWCE-5-PDA5 coil was used in the first two patients and 4～6 mm, 10～12 mm, 12～14 mm Amplatzer occluders were used in the last three patients, respectively. No residual shunt in the first four patients, the echo showed that the heart recovered to normal size in 2 days. The largest PDA added a 5 mm Cook coil, aortographies showed small residual shunt, but the heart was smaller than before the procedure. Three months later, the echo showed that the residual shunt disappeared.
Conclusions: Transcatheter closure of small PDA using coil or of moderate to large PDA using Amplatzer occluder device was a simple, safe, and effective method., 百拇医药
单位：山东省济南市，山东省立医院 儿科(250021) 王玉林 韩 波 刘 芳 张建军 韩秀珍 汪 冀 马沛然；心脏B超室 郭文彬 朱 梅
关键词：
目的 目的：应用Cook弹簧圈及Amplatzer封堵器经导管治疗动脉导管未闭(PDA)患儿并对其进行评价。
方法：根据心脏超声及心血管造影结果选择经股静脉递送Amplatzer或Cook弹簧圈封堵器，一般动脉导管最窄处小于3 mm选用弹簧圈，大于3 mm选用Amplatzer封堵器，术后选择性降主动脉造影及B型超声心动图评价其结果。
结果：5例PDA最窄处直径分别为1.7、1.2、3.1、5.6和8.3 mm,前2例选用Cook公司MWCE-5-PDA5弹簧圈，后3例分别选用4～6 mm、10～12 mm和12～14 mm Amplatzer封堵伞。前4例PDA封堵后即刻杂音消失，主动脉弓降部造影显示无残余分流，2天后超声心动图示心脏大小恢复正常；第5例因导管较粗，压差较大，在用12～14 mm Amplatzer封堵伞的基础上又加用5 mm Cook弹簧圈一个，封堵后仍有少量渗透性残余分流，但复查超声心动图显示心脏较前明显减小。3个月后复查超声心动图残余分流消失。
结论：应用Cook弹簧圈经导管治疗小型动脉导管未闭，Amplatzer封堵器治疗中、大型动脉导管未闭是安全有效的介入方法，操作简单，疗效满意。
Transcatheter Closure of Patent Ductus Arteriosus in Children (Abstract)
Pediatric Department, Shandong Provincial Hospital, Ji′nan (250021), Shandong
Wang Yulin, Han Bo, Liu Fang, et al.
Objective: To evaluate the safty and efficiency of transcatheter closure of patent ductus arteriosus (PDA) using coil or Amplatzer occluder device.
Methods: The narrowest diameter of PDA in five children was 1.7 mm, 1.2 mm, 3.1 mm, 5.6 mm and 8.3 mm, respectively. Cook coil was choosed if the PDA was smaller than 3 mm and Amplatzer was selected if the PDA was larger than 3 mm. Aortographies were performed immediately after the procedure to evaluate the efficiency.
Results: Cook MWCE-5-PDA5 coil was used in the first two patients and 4～6 mm, 10～12 mm, 12～14 mm Amplatzer occluders were used in the last three patients, respectively. No residual shunt in the first four patients, the echo showed that the heart recovered to normal size in 2 days. The largest PDA added a 5 mm Cook coil, aortographies showed small residual shunt, but the heart was smaller than before the procedure. Three months later, the echo showed that the residual shunt disappeared.
Conclusions: Transcatheter closure of small PDA using coil or of moderate to large PDA using Amplatzer occluder device was a simple, safe, and effective method., 百拇医药