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目的 应用Amplatzer动脉导管封堵器治疗小儿动脉导管未闭 (PDA) ,及Amplatzer房间隔缺损 (ASD)封堵器治疗小儿继发孔型ASD ,并评价其疗效。方法 女性PDA住院患者 2例 ,继发孔型ASD女性住院患者 1例 ,确诊为PDA、继发孔型VSD ,不伴其他需外科治疗的先天性心血管畸形。动脉导管最窄处直径分别为 3mm、5mm ,经 6及 7F导管置入AmplatzerPDA封堵器。ASD经心内球囊法测定ASD 10mm。经 7F导管置入AmplatzerASD封堵器。手术在DSA监测下进行。ASD封堵同时在TTE监测下进行。PDA术后 10min进行侧位降主动脉造影 ,术后 2 4h、3d、3、6、12月TTE和X线胸片评价效果。结果 手术全部成功。 1例ASD术后即时TTE检查示立即关闭。 1例PDA术后 10min降主动脉造影及 2 4h后TTE检查有少量残余分流 ,术后第 3天TTE检查分流消失。结论 应用Amplatzer封堵器治疗PDA和继发孔型ASD是一种安全有效的介入治疗方法 ,操作简单 ,成功率高 ,疗效可靠。
Objective To evaluate the efficacy of Amplatzer ductus arteriosus occluder in the treatment of children with patent ductus arteriosus (PDA) and Amplatzer atrial septal defect (ASD) occluder. Methods Two female inpatients with PDA and one inpatient secondary to ASD were diagnosed as PDA and secondary perforation VSD without concomitant congenital cardiovascular malformation. The narrowest diameter of the patent ductus arteriosus was 3 mm and 5 mm, respectively. Amplatzer PDA occluders were inserted through 6 and 7 F catheters. ASD was measured by the endocardial balloon ASD 10mm. Amplatzer ASD occluder was placed through 7F catheter. Surgery under DSA monitoring. ASD occlusion is performed simultaneously with TTE monitoring. PDA 10min after the lateral aortic angiography, 24h, 3d, 3, 6, 12 months after the evaluation of TTE and X-ray. The results of surgery were all successful. One case of post-ASD immediate TTE showed immediate closure. One patient underwent descending aorta angiography at 10 min after PDA and a small residual shunt after T 4 h after operation, and the shunt disappeared on the third day after TTE examination. Conclusion The application of Amplatzer occluder in the treatment of PDA and secondary orifice ASD is a safe and effective method of interventional therapy. It has simple operation, high success rate and reliable curative effect.