Transcatheter Closure Of Congenital Tiny Patent Ductus Arteriosus

Objective:To observe the methods and clinical efficiency of transcatheter closure of tiny patent ductus arterious(dutus narrow diameter≤3mm) through using occluder device and puncturing through femoral artery and femoral veins to establish the rail for interventional therapy of PDA with occluder device,so as to evaluate the artery catheter puncture of the femoral artery and femoral veins of interventional therapy of tiny PDA clinical curative effect.Methods:Twenty- five patients(male 17,female 17) with tiny patent ductus arterious (diameter≤3mm) were treated by transcatheter closure with occluder device through puncturing femoral artery and femoral veins to establish the rail,The mean age was 9.18 years(ranged from 4～33 years old).Selected patients on preoperative ECG, chest radiograph(lung bloodstream,lung and heart rate),echocardiogram(LVED,LAD, LVEF,PASP) and so on.PDA were shown by transthoracic echocardiography(TTE) before interventions.Each case was treated with occluder device through the percutaneous procedure under fluoroscopy and TTE,After the procedure,TTE were perfored immediately to find whether there any residual shunt remained.TTE and chest radiograph were done 24-hour,3-month,6-month,12-month after the procedure to evaluate the efficiency.Results:25 cases of PDA patients,3 patients with other defects[2 cases of ventricular septal defect(VSD) and 1 cases of atrial septal defect(ASD)]were all successful. Using the Amplatzer or domestic occluder device in operation,no occluder break away.1 case occurred hemolysis in postoperation,the condition improved after drug treatment.22 cases(88%) used occluder model were 6/4mm,3 cases(12%) were 8/6mm.There is statistically significant difference between the PDA diameter(2.60 0.3mm) intraoperative angiography and PDA diameter(2.83±0.6mm) in postoperation (P＜0.01).TTE and chest radiograph showed LVED,LAD,LVEF,PASP and cardiothoracic ratio decreased significantly(P＜0.05).Conclnsion:The interventional treatment method of small PDA through puncturing femoral artery and femoral veins to establish the rail is a safe and effective method, which takes a high success rate,less trauma,rapid recovery,and in small and medium-sized ductus treatment reports rarely with certain innovation.