数字减影下儿童动脉导管未闭的分型与封堵器选择的特点分析
摘要
目的:研究儿童动脉导管未闭(PDA)的造影形态及封堵器选择的策略。方法:选取2014年1月-2018年12月我院儿科收治的符合动脉导管未闭诊断标准患儿42例,男15例,女27例,完善相关术前检查后,静脉麻醉下运用Amplatzer法介入封堵动脉导管,术中行降主动脉侧位造影,观察动脉导管的形态并测量直径,选择合适类型的封堵器封堵治疗,术后给予穿刺部位加压包扎,适度镇静治疗,定期复查心脏彩超。结果:42例动脉导管未闭患儿中,造影分别显示管型26例、圆锥型9例、窗型6例、串珠型1例,依据PDA形态及直径的不同分别选用PDA封堵器、VSD封堵器及PDA-ADO-II封堵器封堵治疗,术后未见残余分流及术后并发症的发生,均痊愈出院。结论:通过对PDA分型的分析及认识,有助于临床选择恰当的手术治疗方法,提高手术成功率,减少术后并发症的发生率。
引文
[1]李奋,周爱卿,蒋世良,等.动脉导管未闭封堵的临床研究[J].临床儿科杂志,2006,24:924-926,929
[2]周爱卿,李奋.先天性心脏病心导管术[M].上海:上海科技出版社,2009:229-235
[3] Pillai AA,Satheesh S,Pakkirisamy G,et al.Techniques and outcomes of transcatheter closure of complex atrial septal defects e Single center experience[J].Indian Heart J,2014,(66):e38-e44
[4] Promphan W,Sievert H,Qureshi SA,et al.Interventions in Structural,Valvular,and Congenital Heart Disease[J].New York:CRC Press,2015:469-489
[5] Cinteza EE,Butera G.Complex ventricular septal defects[J].Rom J Morphol Embryol,2016(57):1195-1231
[6] Chessa M,Carminati M,Cintez觍EE,et al.Partial abnormal drainage of superior and inferior caval veins into the left atrium:two case reports[J].Rom J Morphol Embryol,2016(57):559–595
[7] Cintez觍EE,Filip C,Bogdan A,et al.Atretic aortic coarctation-transradial approach[J].Rom J Morphol Embryol,2017(58):1029-1055
[8] Sinha SK,Khanna NN,Razi M,et al.Safety and feasibility of transcatheter interruption of ruptured sinus of valsalva aneurysm using the Cocoon Duct Occluder:immediate results and mid-term follow-up[J].Cardiol Res,2017(8):154-181
[9] Bhalgat PS,Pinto R,Dalvi BV.Transcatheter closure of large patent ductus arteriosus with severe pulmonary hypertension:short and intermediate term results[J].Ann Ped cardiol,2012(5):135-172
[10] Bansal NO,Prabhu S,Ware D,et al.Transcatheter percutaneous device closure of a large PDA closed in a 3kg infant[J].Indian Heart J,2014(166):707–716
[2]周爱卿,李奋.先天性心脏病心导管术[M].上海:上海科技出版社,2009:229-235
[3] Pillai AA,Satheesh S,Pakkirisamy G,et al.Techniques and outcomes of transcatheter closure of complex atrial septal defects e Single center experience[J].Indian Heart J,2014,(66):e38-e44
[4] Promphan W,Sievert H,Qureshi SA,et al.Interventions in Structural,Valvular,and Congenital Heart Disease[J].New York:CRC Press,2015:469-489
[5] Cinteza EE,Butera G.Complex ventricular septal defects[J].Rom J Morphol Embryol,2016(57):1195-1231
[6] Chessa M,Carminati M,Cintez觍EE,et al.Partial abnormal drainage of superior and inferior caval veins into the left atrium:two case reports[J].Rom J Morphol Embryol,2016(57):559–595
[7] Cintez觍EE,Filip C,Bogdan A,et al.Atretic aortic coarctation-transradial approach[J].Rom J Morphol Embryol,2017(58):1029-1055
[8] Sinha SK,Khanna NN,Razi M,et al.Safety and feasibility of transcatheter interruption of ruptured sinus of valsalva aneurysm using the Cocoon Duct Occluder:immediate results and mid-term follow-up[J].Cardiol Res,2017(8):154-181
[9] Bhalgat PS,Pinto R,Dalvi BV.Transcatheter closure of large patent ductus arteriosus with severe pulmonary hypertension:short and intermediate term results[J].Ann Ped cardiol,2012(5):135-172
[10] Bansal NO,Prabhu S,Ware D,et al.Transcatheter percutaneous device closure of a large PDA closed in a 3kg infant[J].Indian Heart J,2014(166):707–716