上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 技术与方法 • 上一篇    下一篇

新型动脉导管未闭封堵器封堵冠状动脉瘘

王 鉴，陈 笋，孙 锟，杨健萍，沈 加，武育蓉   

  1. 上海交通大学 医学院附属新华医院小儿心血管科， 上海 200092
  • 出版日期:2014-12-28 发布日期:2014-12-30
  • 通讯作者: 武育蓉, 电子信箱: 2648458997@qq.com。
  • 作者简介:王 鉴（1988—）， 女， 博士生; 电子信箱: ：jxlucywang@hotmail.com。
  • 基金资助:

    国家自然科学基金（30772349，81070134）；上海市卫生局系统主要疾病联合攻关项目（2013ZYJB0016）；上海市科委产学研医合作项目（12JC1406600）

Closing coronary artery fistula by Amplatzer Duct Occluder Ⅱ

WANG Jian, CHEN Sun, SUN Kun, YANG Jian-ping, SHEN Jia, WU Yu-rong   

  1. Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2014-12-28 Published:2014-12-30
  • Supported by:

    National Natural Science Foundation of China，30772349，81070134； Joint Health Research Program for Major Disease of Shanghai Municipal Health Bureau，2013ZYJB0016；Medical Cooperation Project of Science and Technology Commission of Shanghai Municipality，12JC1406600

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摘要：

目的 介绍使用新型动脉导管未闭封堵器（ADOⅡ）封堵冠状动脉瘘的经验，分析有效性和安全性。方法 收集2011年9月—2013年10月使用ADOⅡ经导管介入封堵冠状动脉瘘患者的临床资料，对手术及术后短期随访情况进行回顾性分析。结果 5例患儿平均年龄3.8岁。4例右冠状动脉—右心室瘘患儿中，3例选择4 mm×6 mm ADOⅡ，5F输送鞘；1例选择4 mm×4 mm ADOⅡ，4F输送鞘。1例左冠状动脉—右心室瘘患儿选择4 mm×4 mm ADOⅡ，5F输送鞘。术中造影及术后心脏超声均显示无残余分流，术后第2日心电图检查结果正常。平均随访16个月，均未发现异常。结论 ADOⅡ的主要优势是输送鞘尺寸小、柔软，容易到达瘘口并能够有效封堵冠状动脉瘘。

关键词: 新型动脉导管未闭封堵器, 冠状动脉瘘, 介入治疗, 儿童

Abstract:

Objective To introduce the experience of using Amplatzer Duct Occluder Ⅱ (ADO Ⅱ) for closing coronary artery fistula and to analyze its efficacy and safety. Methods Clinical data of patients whose coronary artery fistulas were closed by ADO Ⅱ between September 2011 and October 2013 were collected. The retrospective analysis was conducted according to operation and short-term follow-up outcomes. Results The average age of 5 patients was 3.8 years. Among 4 cases of right coronary-right ventricular fistulas, 3 cases used 4 mm×6 mm ADO Ⅱ and 5F delivery sheath, while the other case used 4 mm×4 mm ADO Ⅱ and 4F delivery sheath. One case of left coronary-right ventricular fistula used 4 mm×6 mm ADO Ⅱ and 5F delivery sheath. Intraoperative angiography and postoperative echocardiography showed no residual shunt and the results of electrocardiogram were normal the next day after operations. The average follow-up time was 16 months and no complications were found. Conclusion The delivery sheath of ADO Ⅱ is small and soft, which facilitates for approaching the fistula and efficiently closing the coronary artery fistula.

Key words: Amplatzer Duct Occluder Ⅱ (ADO Ⅱ), coronary artery fistula, catheterization closure, children