摘要目的 探讨超声心动图作为唯一影像学工具引导动脉导管未闭封堵术的安全性和有效性.方法 2013年6月至2014年6月,连续入选单纯动脉导管未闭患者30例,年龄(6.3±2.5)岁,体质量(22.5±7.3)kg,动脉导管直径(3.8 ±0.9)mm.患者均在经胸超声心动图引导下经股动脉行动脉导管未闭封堵术,封堵后以超声心动图评价治疗效果.术后1个月在门诊随访.结果 30例患者均成功在超声心动图引导下完成动脉导管未闭封堵术,手术操作时间为(32.8±5.7) min,Amplatzer ADOⅡ封堵器直径(4.9 ±1.0)mm.6例患者术后早期有微量残余分流,无外周血管损伤及心脏穿孔等并发症.所有患者均康复出院,住院时间为(3.4±0.7)d.术后1个月随访,患者均无残余分流、心包积液等并发症.结论 单纯超声心动图引导下经股动脉行动脉导管未闭封堵术安全、有效,能避免使用X线和对比剂.

abstractsObjective To avoid the radiation injuries and use of contrast agent,we assessed the safety and efficacy of percutaneous patent ductus arteriosus closure solely under thoracic echocardiography guidance.Methods From June 2013 to June 2014,thirty patients (mean age:(6.3 ± 2.5) years,mean body weight:(22.5 ± 7.3) kg) with pure patent ductus arteriosus were continuously included in this study.The mean diameter of patent ductus arteriosus was (3.8 ± 0.9) mm.Patients were all treated by percutaneous patent ductus arteriosus closure via right femoral artery solely under thoracic echocardiography guidance.The efficacy of the procedure was evaluated by thoracic echocardiography.Follow-up was performed at one month after procedure.Results All 30 cases were successfully treated with percutaneous patent ductus arteriosus closure solely under thracic echocardiography guidance.The procedural time was (32.8 ± 5.7) minutes.The mean diameter of Amplatzer ADO Ⅱ was (4.9 ± 1.0) mm.Postoperative trivial residual shunt occurred in six patients immediately after the procedure.All patients survived without peripheral vascular injury or complications such as cardiac perforation.Hospitalization time was (3.4 ± 0.7) days.At one-month follow-up,no complications such as residual shunt or pericardial effusion were observed.Conclusion Echocardiography guided percutaneous patent ductus arteriosus closure by femoral artery approach is safe and effective,and can avoid X-ray and the use of contrast agents.