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超声引导下股静脉路径动脉导管经皮封堵术:一种治疗新策略的可行性和安全性研究(英文)

Echocardiography-guided percutaneous closure of patent ductus arteriosus without arterial access: Feasibility and safety for a new strategy

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【作者】 张伟志高雷金万存吴勤胡世军杨一峰赵天力

【Author】 ZHANG Weizhi;GAO Lei;JIN Wancun;WU Qin;HU Shijun;YANG Yifeng;ZHAO Tianli;Department of Cardiovascular Surgery, Second Xiangya Hospital, Central South University;

【机构】 中南大学湘雅二医院心血管外科

【摘要】 目的:评估超声引导下股静脉路径动脉导管经皮封堵术的可行性和安全性。方法:选择2014年6月至2016年5月在中南大学湘雅二医院就诊的连续102例动脉导管未闭(patent ductus arteriosus,PDA)患儿。所有患儿在单纯超声引导下,经股静脉路径行动脉导管经皮封堵术。术后1,3,6,12,24个月定期随访,随访内容包括临床评估、心电图和超声心动图。结果:99例(97.1%)患儿成功实施超声引导下经股静脉路径动脉导管经皮封堵术。全组病例无急性手术并发症或严重不良事件。手术时间10~65(中位数21) min。87例(87.9%)患儿实现PDA即刻完全闭合,其余12例患儿均在24 h后达到完全闭合。随访时间1~24个月,随访期间无严重并发症发生。结论:超声引导下经股静脉路径动脉导管经皮封堵术避免了放射性暴露,无需造影剂,消除了动脉并发症的潜在风险,是治疗PDA患儿安全且有效的方法。

【Abstract】 Objective: To evaluate the feasibility and safety of device closure of patent ductus arteriosus(PDA) using only venous access under echocardiography guidance alone.Methods: A total of 102 consecutive pediatric patients underwent transcatheter PDA closure without arterial access, under the guidance of only echocardiography. Th e patients were followed up by clinical examination, electrocardiogram, and echocardiogram at 1, 3, 6 12, and 24 months.Results: Transvenous PDA closure under echocardiographic guidance was successful in 99(97.1%) patients. There were no acute procedural complications or severe adverse events. The duration ranged from 10 to 65 minutes(median, 21 minutes). Immediate complete closure of PDA was achieved in 87 patients(87.9%), and 100% of the patients were completely closed af ter 24 h. Th ere were no severe adverse events in the period of 1–24 months(median, 12 months) follow up.Conclusion: Transvenous PDA closure without fluoroscopy avoids radiation exposure, contrast agent usage and potential arterial complications. It can be used as an alternative procedure, especially for children.

  • 【文献出处】 中南大学学报(医学版) ,Journal of Central South University(Medical Science) , 编辑部邮箱 ,2018年09期
  • 【分类号】R725.4
  • 【被引频次】3
  • 【下载频次】76
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