Is the new Occlutech duct occluder an appropriate device for transcatheter closure of patent ductus arteriosus?
Is the new Occlutech duct occluder an appropriate device for transcatheter closure of patent ductus arteriosus?
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DOI：
10.1016/j.ijcard.2018.03.059
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发表时间：
2018-06-15
影响因子：
3.5
通讯作者：
Lucron, Hugues
中科院分区：
文献类型：
--
作者：
Godart, Francois;Houeijeh, Ali;Lucron, Hugues
目的：描述我们使用Occlutech动脉导管未闭封堵器（ODO）经皮封堵动脉导管未闭（PDA）的初步经验。方法：回顾性分析2个学术中心使用ODO经导管PDA封堵术的患者。结果：从2013年4月至2017年9月，42例患者接受了PDA封堵术。植入时的中位年龄为34个月（范围4个月-68岁），中位体重为12 kg（范围4.1-57 kg）。导管为Krichenko A型导管34例，E型导管6例，C型导管2例。平均导管直径为3.76 mm（范围1.69 - 9.95 mm，中位数3.1 mm）。植入全部成功。未发生器械栓塞或溶血。器械释放时，立即血管造影显示54.7%存在少量残余分流。在随访期间，多普勒超声心动图显示第一天71%的完全闭塞，在植入后一个月上升到95%，在一年半时达到100%。左肺动脉的平均最大收缩压梯度为4.2 ± 4.3 mm，主动脉弓远端为5.4 ± 4.7 mm Hg。结论：ODO是经导管封堵动脉导管未闭（包括较大导管）的安全有效的方法。结果是令人满意的高水平的完全闭塞和低并发症的发生率。需要更大规模的研究和更长时间的随访进行进一步评估，以证实这些初步的良好结果。(c)2018由Elsevier B. V.出版
Aim: To describe our initial experience with the Occlutech Duct Occluder (ODO) for percutaneous closure of patent ductus arteriosus (PDA).Methods: Retrospective review of patients undergoing transcatheter PDA closure with the ODO in 2 academic centers.Results: From April 2013 to September 2017, 42 patients underwent PDA closure. Median age at implantation was 34 months (range 4 months-68 years) and median weight was 12 kg (range 4.1-57 kg). Ducts were Krichenko type A duct (n = 34), type E (n = 6), and type C (n = 2). The mean duct diameter was 3.76 mm(range 1.69 to 9.95 mm, median 3.1 mm). Implantation succeeded in all. There was neither device embolization nor hemolysis. At device release, immediate angiogram showed a small residual shunt in 54.7%. During follow-up, Doppler echocardiography demonstrated 71% of full occlusion at day one, rising to 95% at one month and 100% at one year and half after implantation. The mean maximal systolic pressure gradient in left pulmonary artery was 4.2 +/- 4.3 mm and across the distal aortic arch 5.4 +/- 4.7 mm Hg. No patient had any significant stenosis with clinical relevance.Conclusions: ODO is safe and effective in transcatheter closure of PDA including relatively large sized ducts. The results are satisfactory with a high level of full occlusion and a low rate of complications. Further evaluation with larger studies and longer follow-up will be required to confirm these preliminary good results. (c) 2018 Published by Elsevier B.V.