经胸微创封堵术治疗动脉导管未闭38例报告

摘要

目的 总结经胸微创封堵术治疗动脉导管未闭的初步经验.方法 38例手术前均确诊为动脉导管未闭,导管主动脉侧直径4.5～18.3 mm.左前胸2～3 cm切口,在食管超声心动图引导下经输送器置入封堵伞,闭合动脉导管.结果 38例手术均获得成功.术后出现2例肺炎,1例中等量心包积液,均治愈.术后3个月复查超声心动图提示肺动脉压力[(36±15) mmHg]较术前[(55±20) mmHg]显著降低(P＜0.05).随访3～24个月,封堵伞无移位、无残余分流.结论 经胸微创封堵手术治疗动脉导管未闭具有安全、高效的优点,适合各年龄组动脉导管未闭.%Objective To summarize the experience of applying microinvasive surgical transthoracic occlusion in the treatment of patent ductus arteriosus (PDA). Methods A total of 38 patients with PDA were given micro-invasive surgical transthoracic occlusion. The diameter of PDA was 4.5~18.3 mm. An incision of 2~3 cm in length was made on the left anterior chest. A special occluder was inserted to close PDA under the guidance of transesopha-geal echocardiography. Results All the patients were successfully occluded. Pneumonia happened in two patients after the procedure. Moderate amount of pericardial effusion occurred in one patient. They were cured. Echocardiography at three months after operation showed significant relief of pulmonary artery hypertension, from (55± 20) mmHg to (36±15) mmHg (P<0.05). The patients were followed up for 3-24 months, (14.5±8.2) months in average, no dislocation of the device or arterial shunt was found. Conclusion Microinvasive surgical transthoracic occlusion is safe and efficient for the closure of PDA, which is suitable for patients in various age ranges.