关键词: 成人, 复杂动脉导管未闭, 介入治疗

Abstract: Objective To evaluate one-year follow-up results of transcatheter intervention for complex patent ductus arteriosus(PDA) in adults. Methods From Jan. 2004 to April 2008, 112 adult patients〔43 male, 69 female, mean age(34±19)years〕 with complex PDA underwent transcatheter intervention in Beijing Anzhen Hospital. Coils were used for patients with small PDA(minimal ductal diameter<3.0 mm), and Amplatzer duct occluders or China-made mushroom shape occluders were used for patients with moderate-to-large PDA(minimal ductal diameter≥3.0 mm). If the conventional technique could not establish the delivery railway, retrograde technique was alternative. In addition to the common practice, all kinds of special tricks were used for the complex PDA patients. Follow-up with color Doppler ultrasound were given at 1 week, 1, 3, 6 and 12 months after the successful interventions. Results The total successful rate was 93.8%, and the rate of residual shunts was 1.8% at the end of 12 months follow-up. All the residual shunts were minimal and no special treatment were needed. The peak systolic pulmonary pressures decreased by 35 mmHg(1 mmHg=0.133 kPa) significantly〔pre-intervention(94±21)mmHg vs post-intervention(58±20)mmHg, P<0.001〕. No procedure-related severe complications (including deaths, recanalization, dislocation of occluders, stenosis of aorta or pulmonary artery) occurred. Some patients developed hemolysis or arterial complications, and all were cured by conservative therapy. Conclusion Transcatheter intervention is an effective and safe treatment for adults PDA patients with complex anatomic or hemodynamic conditions.

Key words: adults, complex patent ductus arteriosus, transcatheter intervention