微导管微导丝技术治疗患儿极细小动脉导管未闭的临床应用The clinical application of micro-catheter and micro-guidewire rail technique in transcatheter closure for children with very small patent ductus arteriosus
耿文磊,胡海波,吕建华,刘垚,徐亮,徐仲英,张戈军,潘湘斌
摘要(Abstract):
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。
关键词(KeyWords): 动脉导管未闭;介入治疗;先天性心脏病
基金项目(Foundation):
作者(Author): 耿文磊,胡海波,吕建华,刘垚,徐亮,徐仲英,张戈军,潘湘斌
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