• 青海省心腦血管病專科醫(yī)院心胸外科, 西寧810012;

目的總結(jié)主動脈覆膜支架腔內(nèi)隔絕術(shù)治療成人巨大動脈導(dǎo)管未閉( PDA)的經(jīng)驗,并對其療效進(jìn)行評價。方法回顧性分析 2010年 9月至 2011年 8月青海省心腦血管病專科醫(yī)院 8例 PDA患者行主動脈覆膜支架腔內(nèi)隔絕術(shù)治療的臨床資料,其中男 5例,女 3例;年齡(30.4±9.3)歲。主動脈造影顯示 PDA最窄內(nèi)徑為(21.0±3.0)mm;肺動脈收縮壓( 76.6±9.4)mm Hg。結(jié)果 8例患者中 7例一次性隔絕成功。術(shù)后即刻血管造影顯示 6例動脈導(dǎo)管完全封閉, 2例殘余少量左向右分流。術(shù)后 2周超聲心動圖及大血管 CT血管造影顯示:殘余分流消失,肺動脈收縮壓( 43.5±7.2)mm Hg,顯著降低。術(shù)后左心室舒張期末內(nèi)徑較術(shù)前明顯減小[(52.0±5.2) mm vs.(69.0±11.1)mm]。隨訪 8例,隨訪時間 1~ 11(7.2±1.1)個月,隨訪期間胸部 X線示:肺血明顯減少,心胸比率明顯減小。結(jié)論應(yīng)用主動脈覆膜支架腔內(nèi)隔絕術(shù)治療成人巨大 PDA是一種安全、有效的方法。

引用本文: 毛文凱,王黎明,祁國榮等. 主動脈覆膜支架腔內(nèi)隔絕術(shù)治療成人巨大動脈導(dǎo)管未閉. 中國胸心血管外科臨床雜志, 2012, 19(2): 202-204. doi: 復(fù)制

1.  Roques F, Hennequin JL, Sanchez B, et al. Aortic stent-graft for patent ductus arteriosus in adults: the aortic exclusion technique. Ann Thorac Surg, 2001, 71 (5):1708-1709.
2.  Lai YQ, Xu SD, Li ZZ, et al. Thoracic endovascular aortic repair of adult patent ductus arteriosus with pulmonary hypertension. J Thorac Cardiovasc Surg, 2008, 135 (3):699-701.
3.  李進(jìn)華, 來永強, 許尚棟, 等. 覆膜支架在成人動脈導(dǎo)管未閉合并肺動脈高壓的臨床應(yīng)用. 中華胸心血管外科雜志, 2009, 25 (5):309-311.
4.  張懷軍, 許建屏, 孫立忠, 等. 成人動脈導(dǎo)管未閉的手術(shù)方法與療效.中國胸心血管外科臨床雜志, 2003, 10 (2):143-144.
5.  丁盛, 劉寶玉, 俞永康, 等. 動脈導(dǎo)管未閉合并重度肺動脈高壓患者的介入與外科治療.中國胸心血管外科臨床雜志, 2010, 17 (3):250-251.
6.  Yan C, Zhao S, Jiang S, et al. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults.Heart, 2007, 93 (4):514-518.
7.  Pass RH, Hijazi Z, Hsu DT, et al. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial: initial and one-year results.J Am Coll Cardiol, 2004, 44 (3):513-519.
8.  Roques F, Hennequin JL, Sanchez B, et al. Aortic stent-graft for patent ductus arteriosus in adults: the aortic exclusion technique.Ann Thorac Surg, 2001, 71 (5):1708-1709.
9.  Saito N, Kimura T, Toma M, et al. Transcatheter closure of patent ductus arteriosus with the Inoue single-branched stent graft. J Thorac Cardiovasc Surg, 2005, 130 (4):1203-1204.
10.  Rehders TC, Petzsch M, Ince H, et al. Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta: risk and relevance. J Endovasc Ther, 2004, 11 (6):659-666.
11.  蔣米爾, 陸民, 黃新天, 等.國產(chǎn)覆膜支架腔內(nèi)修復(fù)術(shù)治療主動脈病變的療效. 上海第二醫(yī)科大學(xué)學(xué)報, 2005, 25 (11):1160.
  1. 1.  Roques F, Hennequin JL, Sanchez B, et al. Aortic stent-graft for patent ductus arteriosus in adults: the aortic exclusion technique. Ann Thorac Surg, 2001, 71 (5):1708-1709.
  2. 2.  Lai YQ, Xu SD, Li ZZ, et al. Thoracic endovascular aortic repair of adult patent ductus arteriosus with pulmonary hypertension. J Thorac Cardiovasc Surg, 2008, 135 (3):699-701.
  3. 3.  李進(jìn)華, 來永強, 許尚棟, 等. 覆膜支架在成人動脈導(dǎo)管未閉合并肺動脈高壓的臨床應(yīng)用. 中華胸心血管外科雜志, 2009, 25 (5):309-311.
  4. 4.  張懷軍, 許建屏, 孫立忠, 等. 成人動脈導(dǎo)管未閉的手術(shù)方法與療效.中國胸心血管外科臨床雜志, 2003, 10 (2):143-144.
  5. 5.  丁盛, 劉寶玉, 俞永康, 等. 動脈導(dǎo)管未閉合并重度肺動脈高壓患者的介入與外科治療.中國胸心血管外科臨床雜志, 2010, 17 (3):250-251.
  6. 6.  Yan C, Zhao S, Jiang S, et al. Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults.Heart, 2007, 93 (4):514-518.
  7. 7.  Pass RH, Hijazi Z, Hsu DT, et al. Multicenter USA Amplatzer patent ductus arteriosus occlusion device trial: initial and one-year results.J Am Coll Cardiol, 2004, 44 (3):513-519.
  8. 8.  Roques F, Hennequin JL, Sanchez B, et al. Aortic stent-graft for patent ductus arteriosus in adults: the aortic exclusion technique.Ann Thorac Surg, 2001, 71 (5):1708-1709.
  9. 9.  Saito N, Kimura T, Toma M, et al. Transcatheter closure of patent ductus arteriosus with the Inoue single-branched stent graft. J Thorac Cardiovasc Surg, 2005, 130 (4):1203-1204.
  10. 10.  Rehders TC, Petzsch M, Ince H, et al. Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta: risk and relevance. J Endovasc Ther, 2004, 11 (6):659-666.
  11. 11.  蔣米爾, 陸民, 黃新天, 等.國產(chǎn)覆膜支架腔內(nèi)修復(fù)術(shù)治療主動脈病變的療效. 上海第二醫(yī)科大學(xué)學(xué)報, 2005, 25 (11):1160.