第Ⅱ代动脉导管未闭封堵器栓塞幼儿体肺侧支的临床应用Clinical study application of Amplatzer duct occluder Ⅱ to occlude aortopulmonary collateral arteries
万俊义,张戈军,徐仲英,蒋世良,金敬琳,李世国,胡海波,宋会军,闫朝武,刘琼,徐亮
摘要(Abstract):
目的探讨Amplatzer第Ⅱ代动脉导管未闭封堵器(amplatzer duct occluderⅡ,ADOⅡ)栓塞幼儿体肺侧支的可行性及效果。方法入选2014年3月3日至2015年4月1日7例患儿(其中男6例,女1例)选用ADOⅡ栓塞体肺侧支,栓塞后行选择性体肺侧支造影,观察封堵器的位置、形态及封堵效果。结果 7例介入栓塞患儿,年龄5~71个月,体质量4.2~22.0 kg。有6例患儿栓塞成功,1例栓塞后出现严重低氧血症放弃介入治疗,择期行外科体肺侧支结扎术。介入栓塞15支体肺侧支,共用ADOⅡ7枚、COOK公司不可控弹簧圈22枚和波科公司可控微弹簧圈2枚。即刻造影示无残余分流2例,少量残余分流4例,少-中量残余分流1例。6例介入成功患儿立即行外科术,其中5例行肺动脉闭锁根治术,1例行体肺分流术。外科术中回血不多、未见死亡,随访未见溶血及外周血管损伤等并发症发生。结论 ADOⅡ可控性高、输送鞘小、对血管损伤小,应用于幼儿合并较粗大、迂曲体肺侧支的介入治疗是安全可行的。
关键词(KeyWords): 动脉导管未闭封堵器;介入栓塞;体肺侧支血管
基金项目(Foundation):
作者(Author): 万俊义,张戈军,徐仲英,蒋世良,金敬琳,李世国,胡海波,宋会军,闫朝武,刘琼,徐亮
参考文献(References):
- [1]Hjortdal VE,Redington AN,de Leval MR,et al.Hybrid approaches to complex congenital cardiac surgery.Eur J Cardiothorac Surg,2002,22(6):885-890.
- [2]刘迎龙,沈向东,李守军,等.介入及手术联合矫治伴有体肺动脉侧支的肺血减少型先天性心脏病.中华医学杂志,2006,86(4):228-231.
- [3]卢蓉,尚小珂,沈群山,等.法洛四联症合并体肺侧支血管一站式镶嵌治疗的临床效果.中国介入心脏病学杂志,2014,22(10):617-620.
- [4]Sivakumar K,Krishnan P,Pieris R,et al.Hybrid approach to surgicalcorrection of tetralogy of Fallot in all patients with functioning Blalock Taussigshunts.Catheter Cardiovasc Interv,2007,70(2):256-264.
- [5]Galantowicz M,Cheatham JP,Phillips A,et al.Hybrid approachfor hypoplastic left heart syndrome:intermediate results after thelearning curve.Ann Thorac Surg,2008,85(6):2063-2070.
- [6]Perry SB,Radtke W.Fellous KE,et al.Coilembolization to occlude aortopulmonary collateral vessels andshunts in patients with congenital heart disease.J Am Coll Cardiol,1989,13(1):100-108.
- [7]Beck A,Dagan T,Matitiau A,et al.Transcatheterclosure of pulmonary arteriovenous malformations with amplatzerdevices.Catheter Cardiovasc Interv,2006,67(6):932-937.
- [8]Cassese S,Losi MA,Rapacciuolo A.Transradial approach for percutaneous closure of patent ductus arteriosus with the Amplatzer duct occludeⅡ:A case report.Catheter Cardiovasc Interv,2011,77(1):103-107.