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目的:评价应用Amplatzer封堵器治疗儿童房间隔缺损(ASD)和动脉导管未闭(PDA)的效果、安全性及并发症等。方法:超声心动图及临床诊断为ASD、PDA患儿,在透视或(和)经胸超声心动图(TTE)下置入Amplatzer封堵器,术后24 h、1、3、6个月、1年及以后每年分别经胸超声、心电图和X线胸片检查评价治疗效果。结果:16例ASD患儿,球囊测量值为13.0～28.0 mm[(19.3±4.9)mm],选择封堵器的直径为13.0～30.0 mm[(20.6±5.1)mm];25例PDA患儿,造影测量值为2.0～7.7 mm[(3.9±1.5)mm],选择封堵器的直径为4.0～12.0 mm[(6.6±1.9)mm]。技术成功率为100％,术中未发生任何并发症,无急诊手术病例。术后即刻造影或TTE显示10例存在残余分流,术后3月TTE检查所有病例无残余分流和再通,肺动脉压下降。结论:应用Amplatzer封堵器治疗小儿PDA和ASD,具有操作简单、安全、损伤小、成功率高等优点,适合于儿童继发孔型ASD及各种类型PDA的介入治疗。
Objective: To evaluate the efficacy, safety and complications of Amplatzer occluder in the treatment of children with atrial septal defect (ASD) and patent ductus arteriosus (PDA). Methods: Echocardiography and clinical diagnosis of ASD, PDA in children undergoing fluoroscopy or (and) transthoracic echocardiography (TTE) Amplatzer occluder placed at 24 h, 1, 3, 6 months after surgery, 1 year and after each year by transthoracic echocardiography and chest X-ray examination to evaluate the therapeutic effect. Results: In 16 children with ASD, the balloon measurement ranged from 13.0 to 28.0 mm [(19.3 ± 4.9) mm] and the diameter of the occluder was 13.0 to 30.0 mm [(20.6 ± 5.1) mm] For children, angiographic measurements ranged from 2.0 to 7.7 mm [(3.9 ± 1.5) mm] and occluder diameters ranged from 4.0 to 12.0 mm [(6.6 ± 1.9) mm]. Technical success rate was 100%, intraoperative no complications, no emergency surgery cases. Immediate postoperative angiography or TTE showed residual shunt in 10 cases. There was no residual shunt and recanalization in all cases after TTE in March, and pulmonary artery pressure decreased. Conclusion: Amplatzer occluder is an effective and safe method for the treatment of PDA and ASD in children. It is suitable for the interventional treatment of children with secondary perforation ASD and various types of PDA.