摘要
目的 评价用Amplatzer封堵器治疗房间隔缺损 (ASD)及动脉导管未闭 (PDA)的疗效与安全性。方法 5 0例(男 2 3例、女 2 7例 ,年龄 3～ 64岁 )中ASD 19例、PDA 3 1例 ,按常规在局麻或全麻下完成心导管检查及造影。ASD封堵时先用测量球囊测ASD直径及选取Amplatzer封堵器 ,经传送装置将封堵器推送至左房 ,先后释放左、右侧盘 ,心脏超声证实ASD封堵完全、无残余分流、不影响二尖瓣活动时 ,再将Amplatzer封堵器完全释放。PDA患者先行主动脉弓降部侧位造影 ,测量PDA直径及选择Amplatzer蘑菇伞封堵器 ,经传送装置将封堵器置于未闭的动脉导管内 ,重复主动脉造影证实无残余分流时释放封堵器。结果 ① 19例ASD患者球囊测得的ASD直径为 2 3± 6( 13～ 3 1)mm ,所用封堵器直径为 17～ 40mm ,均一次性封堵成功。② 3 1例PDA患者中 3 0例用Amplatzer蘑菇伞封堵成功 ,1例PDA内径达 12mm者用直径 17mm的Amplatzer房间隔封堵器封堵成功。无并发症发生。结论 用Amplatzer封堵器治疗ASD及PDA具有操作简便、疗效肯定、创伤小、适应症广及并发症少的特点 。
Objective To evaluate the therapeutic efficacy and safety of transcatheter closure of atrial septal defect (ASD) and patent ductus arteriosus (PDA) using Amplatzer occluder. Methods Routine cardiac catheterization and angiography were performed in 50 patients (23 male, 27 female, age ranging from 3 to 64 years old), including 19 cases of ASD and 31 cases of PDA under local or general anesthesia. After balloon sizing of the ASD, the optimal Amplazter septal occluder (ASO) was transmitted into the left atrial, and the left and right disks were released in turn. The Amplatzer occluder was completely released after transthoracic echocardiography confirmed that there was no residual shunts or new onset mitral valve regurgitation. The Amplatzer duct occluder (ADO) size was selected according to the narrowest point of PDA measured by angiography, and the occluder was released after the repeated angiography showed no residual shunts. Results ① The mean diameter of the ASD measured by balloon was 13-31 (23±6) mm and the diameter of ASO was (17-40) mm. The immediate closure rate was 100%. ② Angiography confirmed that closure of the ductus using ADO was achieved in 30 patients, and closure of the large size (12 mm) was achieved in 1 case of PDA patient using ASO (17 mm). No complications were encountered. Conclusion Transcatheter closure of ASD and PDA using Amplatzer device, with the advantages of simple operation, confirmative occlusion efficacy, minimal invasiveness, wide indications, and less complications, has a bright future of clinical application.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2004年第7期637-639,共3页
Journal of Third Military Medical University
