Transcatheter Closure of Large Patent Ductus Arteriosus Using the Amplatzer Ductal Occluder

經心導管使用安普拉茲封堵器關閉大型存開性動脈導管

林明志(Ming-Chih Lin) ； 傅雲慶(Yun-Ching Fu) ； 詹聖霖(Sheng-Ling Jan) ； 何季麟(Chi-Lin Ho) ； 遲景上(Ching-Shiang Chi) ； 黃碧桃(Betau Hwang)

《Acta Cardiologica Sinica》 23卷2期 (2007/06) Pp. 103-108

摘要

背景　彈簧圈適合用來關閉小的存開性動脈導管，但不建議用於大型的動脈導管。本文報導我們使用安普拉茲封堵器經心導管關閉大型存開性動脈導管的初期經驗。
方法　從2002年4月到2006年10月，我們收集所有使用安普拉茲封堵器經心導管關閉大於3.5mm的存開性動脈導管的病人。放置後十分鐘以血管攝影評估成果，並於24小時，1個月，3個月，6個月，及12個月後以彩色杜卜勒超音波追蹤。
結果　總共9個女性及7個男性。年齡中位數為25.4歲（0~72.6歲），體重中位數為54.2公斤（7.8-85.0公斤），存開性動脈導管直徑中位數為4.3mm(3.6-10.5mm)，肺血流量與主動脈血流量比值中位數為1.98(1.23~2.44)。其中三個病人術後十分鐘有輕微殘餘分流，所有病人淤術後三個月均達到完全關閉。無顯著左肺動脈狹窄、主動脈弓縮窄或其他併發症。
結論　由我們有限之經驗，使用安普拉茲封堵器治療大型存開性動脈導管是安全且有效的。

關鍵字

安普拉茲封堵器 ； 心導管 ； 存開性動脈導管

並列摘要

Background: Coils are suitable for the closure of a small patent ductus arteriosus (PDA) but are not recommended for a large PDA. We reported our initial experience of transcatheter closure of a large PDA using the Amplatzer ductal occluder (ADO).
Methods: From April 2002 to October 2006, all patients with ductal size greater than 3.5mm undergoing transcatheter closure of PDA using the ADO were collected. The results were evaluated by aortography at 10 minutes and by color Doppler echocardiography at 24 hours, 1 month, 3 months, 6 months and 12 months after the procedure.
Results: There were 9 females and 7 males. The median age was 25.4 years (0.9-72.6 years). The median body weight was 54.2 kg (7.8-85.0kg). The median ductal size was 4.3 mm (3.6-10.5mm). The median Qp/Qs was 1.98 (1.23-2.44). Three patients had tiny residual shunt immediately after the procedures. All patients had achieved complete closure at 3 months of follow-up. There were no significant left pulmonary artery stenosis, coarctation of the aorta or other complications.
Conclusion: From our limited experience, ADO is safe and effective for the closure of a large PDA.

並列關鍵字

Amplatzer ductal occluder ； Heart catheterization ； Patent ductus arteriosus