Zhang Qing,Wu Qi,Yang Shuai,et al.Summary of treatment experience of percutaneous ADOⅡ closure for pediatric patent ductus arteriosus under simple transthoracic echocardiography[J].Journal of Clinical Pediatric Surgery,,18():763-766.[doi:10.3969/j.issn.1671-6353.2019.09.011]
Summary of treatment experience of percutaneous ADOⅡ closure for pediatric patent ductus arteriosus under simple transthoracic echocardiography
- Keywords:
- Echocardiography; Transthoracic; Ductus Arteriosus; Patent; Occlusion; ADO Ⅱ Occluder; Child
- CLC:
- R726;R540.4+5;R540.4+6
- Abstract:
- Objective To summarize the clinical experiences of transthoracic echocardiography (TTE) as a sole imaging tool and the application of ADOⅡ occluder for patent ductus arteriosus (PDA).Methods A retrospective analysis was performed for 68 children undergoing PDA closure under TTE from July 20,2019 to June 2019.There were 38 boys and 30 girls with an average age of (29.35±16.52) months and an average body weight of (13.09±4.19) kg.The aortic end of PDA,the inner diameter of pulmonary artery,the innermost diameter of apex and the length of PDA were measured by TTE pre-operation and a suitable occluder was selected according to the measurements.Intraoperative femoral artery access was employed for monitoring the whole process of PDA ADOⅡ closure under TTE guidance.Observations were made at 1 day post-operation and the follow-up period was 1 to 6 months.Results The average opening diameter of pulmonary artery end was (2.38±0.97) mm,the average opening diameter of aortic end (4.48±2.70) mm and the average length of PDA 5.37±1.42 mm.The average size of ADOⅡ was (4.46±1.20) mm and the average length (4.38±0.79) mm,including 27 cases of tube type and 41 cases of funnel shape.All 64 patients underwent percutaneous PDA occlusion under the guidance of TTE.The average operative duration was (11.16±5.18) min.Four patients underwent X-ray guided percutaneous PDA occlusion.The average postoperative hospital stay was(3.24±1.24) days,the average hospitalization cost (23732.20±1686.02) yuan and the follow-up period 1 to 6 months.There was no instance of occluder displacement,residual shunt or pulmonary artery and aortic flow rate increase,upper/lower limb blood pressure abnormalities,valve damage,pericardial effusion,mechanical hemolysis,peripheral vascular damage or other complications.Conclusion Under the guidance of TTE alone,the feasibility and success rate of ADOⅡ percutaneous closure of infantile PDA are high so that radiography and contrast agent may be avoided.For PDAs with small pulmonary opening,an intervention plan is required.
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Memo
收稿日期:2017-06-25。
基金项目:浙江省科技厅国际科技合作高技术产业联合研发项目（编号：2016C54006）
通讯作者:徐玮泽,Email:120heart@zju.edu.cn