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对18例小儿动脉导管未闭(PDA)、4例房间隔缺损(ASD)、1例室间隔缺损均经导管由静脉途径置入Amplatzer封堵器,术中即刻造影或心脏超声检查证实封堵完全,术后1 d、1个月行超声心动图检查观察有无残余分流。结果:23例均封堵成功,24 h复查心脏彩超提示21例封堵完全,2例PDA残余分流,1周和1个月后复查分流均消失。1例PDA合并PS者,鉴于跨肺动脉瓣膜的压力阶差△P29mmHg,仅封堵PDA;1例外科修补术后残余分流的多发室间隔缺损,术中造影证实为上下位排列的2处、直径为2 mm和5 mm、较为接近的分流口,选择腰部直径为6 mm的偏心型Amplatzer VSD封堵器封堵其中大的分流口,造影显示完全封堵其中大的分流口,同时部分性阻断小的分流口,超声和造影显示另一分流口直径在1~2 mm以内,达到预期的效果。认为只需病例选择得当,经导管介入治疗PDA、ASD、VSD是适用于小儿的安全有效、操作简便治疗方法。
18 cases of pediatric patent ductus arteriosus (PDA), 4 cases of atrial septal defect (ASD), 1 case of ventricular septal defect were catheterized by intravenous approach Amplatzer occluder, intraoperative angiography or echocardiography confirmed the closure Complete, 1 d after surgery, 1 month underwent echocardiography to check for residual shunt. Results: Twenty - three cases were successfully blocked. Twenty - one cases of 24 cases were retrospectively reviewed. All cases were completely occluded. Two cases of PDA residual shunt, one week and one month later, all shunt disappeared. One case of PDA combined with PS, in view of the pressure gradient across the pulmonary valve △ P29mmHg, only PDA; 1 case of residual shunt after surgical repair of multiple ventricular septal defect, intraoperative angiography confirmed the upper and lower arranged 2, diameter For 2 mm and 5 mm, the more proximal shunt, select the eccentric diameter Amplatzer VSD occluder 6 mm in diameter, which blocked the large shunt, which completely blocked the large shunt, while the partial resistance Broken small shunt, ultrasound and contrast showed that the diameter of the other shunt within 1 ~ 2 mm, to achieve the desired results. That only appropriate choice of cases, transcatheter treatment of PDA, ASD, VSD is safe and effective for children, easy to operate treatment.