单纯超声引导下经股静脉行动脉导管封堵术的应用研究
Application research of percutaneous patent ductus arteriosus closure by femoral vein approach under echocardiography guidance
目的 为了避免放射线及造影剂的损伤,探讨使用超声心动图作为唯一影像学工具进行经股静脉行动脉导管未闭(PDA)封堵术的有效性和安全性.方法 入选阜外心血管病医院2014年1-12月单纯PDA患者25例,年龄(4.5±2.1)岁,体质量(19 ±7) kg,动脉导管直径(5.9±1.2) mm.患者均在经胸超声心动图引导下经股静脉行PDA封堵术,封堵后以超声心动图检查评价治疗效果.术后1个月在门诊随访.结果 23例患者成功在经朐超声心动图引导下完成经股静脉PDA介入封堵术.2例患者因导丝不能通过PDA,改为超声引导下经股动脉封堵成功.手术操作时间为(33 ±5) min,PDA蘑菇状封堵器直径(11.4±1.5) mm.3例患者术后即刻存在微量残余分流,所有患者康复出院,无外周血管损伤及心脏穿孔等并发症.住院时间为(3.6±0.8)d.术后1个月随访时均无残余分流、心包积液等并发症.结论 超声心动图引导下经股静脉介入治疗动脉导管未闭不仅安全有效,而且能避免使用放射线和造影剂.
更多Objective To avoid the injuries of radiation and contrast agent,we assess the efficacy and safety of percutaneous patent ductus arteriosus (PDA) closure by femoral vein approach solely under echocardiography guidance.Methods From January 2014 to December 2014,25 patients in Fuwai hospital with PDA were selected,with mean age (4.5 ± 2.1) years and mean body weight (19 ± 7) kg.The mean diameter of PDA was (5.9 ± 1.2) mm.Patients were all treated by percutaneous PDA closure solely by echocardiography guidance in femoral vein.The effect of the procedure was evaluated by echocardiography.Follow-up was given at one month after procedure.Results Twenty-three cases were successfully treated with percutaneous PDA closure by femoral vein approach solely under echocardiography guidance,while two patients was closed by femoral artery approach because guide wires could not pass through PDA.The procedural time was (33 ± 5) min.The mean diameter of PDA occluder was (11.4 ± 1.5) mm.Postoperative early trivial residual shunt occurred in three patients.All patients survived with no peripheral vascular injury or complications such as cardiac perforation.Hospitalization time was (3.6 ± 0.8)days.At one month follow-up,no complications such as residual shunt or pericardial effusion were occurred.Conclusion Echocardiography guided percutaneous PDA closure by femoral vein approach is safe and effective,and avoids the use of radiation and contrast agents.
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