国产Amplatzer蘑菇伞介入治疗中老年动脉导管未闭的近中期疗效分析

目的：评价国产Amplatzer蘑菇伞介入治疗中老年动脉导管未闭（patentductusarteriosus，PDA）的近中期临床疗效及安全性。方法：选择2007年1月至2011年12月我院收治的32例中老年PDA患者，经临床、心电图、x线及经胸超声心动图（TTE）检查确诊，均成功行介入治疗。术后行心电图、x线胸片、TTE随访。结果：32例均1次封堵成功，成功率100％。无重要并发症发生。随访x线胸片显示肺血较术前减少，心胸比率不同程度缩小。术后48小时（32例）超声心动图显示左房内径（LAD）、左室舒张末内径（LVDd）及肺动脉收缩压（PASP）较封堵前明显缩小（P〈0．01）；术后1、3、6月（32例）超声心动图随访显示LAD及LVDd、PASP进一步缩小；术后1年（30例）、术后2年（20例）、术后3年（12例）、术后4年（5例）超声心动图随访显示心脏大小及肺动脉收缩压恢复正常。结论：国产Amplatzer蘑菇伞介入治疗中老年PDA具有操作简单、创伤小、安全且技术成功率高、住院时间短等优点，近中期疗效明确，并发症少。

The Short and Intermediate Term Efficacy of Transcatheter Closure by Homemade Amplatzer Mushroom Occluder

Objective： To evaluate the short and intermediate term efficacy as well as safety of transcatheter closure by homemade Amplatzer mushroom occluder of patent ductus arteriosus in the treatment of middle-aged or geratic patients. Methods： 32 cases with PDA who were confirmed by clinical manifestation, electrocardiogram （ECG）, X-ray fluoroscopy, transthoracic color Doppler echocardiography （TTE） from January 2007 to December 2011 were selected and received the transcatheter occlusion. Then the follow-ups were conducted. Results： 32 cases were all successfully occluded with the rate of 100%. In follow-ups, X-ray fluoroscopy showed pulmonary venous pleonaemia reduced and cardio-thoracic ration decreased. After 48 hours, the LAD, LVDd and PASP reduced obviously （P〈0.01）; after 1 year （30 cases）, 2 years （20 cases）, 3 years （12 cases） and 4 years （5 cases）. There was no death, complication or therapy. Conclusion： Transcatheter closure of PDA in middle-aged or geratic patients using the homemade Amplatzer mushroom occluder was safety and efficacy with easy procedure, less complication, high successful rate and shorter hospitalization.