TRANSCATHETER CLOSURE OF A LARGE PATENT DUCTUS-ARTERIOSUS WITH THE CLAMSHELL SEPTAL UMBRELLA

被引:58
作者
BRIDGES, ND [1 ]
PERRY, SB [1 ]
PARNESS, I [1 ]
KEANE, JF [1 ]
LOCK, JE [1 ]
机构
[1] HARVARD UNIV,SCH MED,DEPT PEDIAT,BOSTON,MA 02115
关键词
D O I
10.1016/0735-1097(91)90551-J
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In 14 patients undergoing transcatheter closure of a large (> 4 mm diameter) patent ductus arteriosus, occlusion was attempted with use of the Bard Clamshell septal umbrella. Patient age ranged from 0.7 to 30.4 years. Isolated patent ductus arteriosus was present in 11 patients; 3 had additional congenital heart lesions. Moderate or severe pulmonary hypertension was present in four patients. The diameter of the patent ductus arteriosus ranged from 4.5 to 14 mm, as determined by contrast injection through an 11F sheath or by balloon sizing; it appeared larger by this method than by the standard angiographic method. All 14 patent ductus arteriosi were successfully closed. Prior embolization of a Rashkind umbrella was the reason for using a Clamshell device in three patients; one additional embolization of a Clamshell device occurred. All errant devices were retrieved at cardiac catheterization, without associated hemodynamic instability. No other complications occurred. Among the 14 patients, 11 had complete ductal closure by Doppler color flow mapping at last follow-up and 3 had trivial residual flow. All four patients having associated complex lesions or pulmonary hypertension, or both, had symptomatic improvement after the procedure, although one child (with Shone's anomaly) died 3 months later. The Clamshell device provides stable and effective closure of a large patent ductus arteriosus, and allows transcatheter closure to be offered to some patients who were previously considered unsuitable for this procedure.
引用
收藏
页码:1297 / 1302
页数:6
相关论文
共 14 条
[1]   BAFFLE FENESTRATION WITH SUBSEQUENT TRANSCATHETER CLOSURE - MODIFICATION OF THE FONTAN OPERATION FOR PATIENTS AT INCREASED RISK [J].
BRIDGES, ND ;
LOCK, JE ;
CASTANEDA, AR .
CIRCULATION, 1990, 82 (05) :1681-1689
[2]  
COLTON T, 1974, STAT MED, P219
[3]   CATHETER OCCLUSION OF THE PERSISTENTLY PATENT DUCTUS-ARTERIOSUS [J].
DYCK, JD ;
BENSON, LN ;
SMALLHORN, JF ;
MCLAUGHLIN, PR ;
FREEDOM, RM ;
ROWE, RD .
AMERICAN JOURNAL OF CARDIOLOGY, 1988, 62 (16) :1089-1092
[5]   MEASUREMENT OF ATRIAL SEPTAL-DEFECT DURING CARDIAC-CATHETERIZATION - EXPERIMENTAL AND CLINICAL RESULTS [J].
KING, TD ;
THOMPSON, SL ;
MILLS, NL .
AMERICAN JOURNAL OF CARDIOLOGY, 1978, 41 (03) :537-542
[6]   ANGIOGRAPHIC CLASSIFICATION OF THE ISOLATED, PERSISTENTLY PATENT DUCTUS-ARTERIOSUS AND IMPLICATIONS FOR PERCUTANEOUS CATHETER OCCLUSION [J].
KRICHENKO, A ;
BENSON, LN ;
BURROWS, P ;
MOES, CAF ;
MCLAUGHLIN, P ;
FREEDOM, RM .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 63 (12) :877-880
[7]   TRANSCATHETER CLOSURE OF PATENT DUCTUS-ARTERIOSUS IN PEDIATRIC-PATIENTS [J].
LATSON, LA ;
HOFSCHIRE, PJ ;
KUGLER, JD ;
CHEATHAM, JP ;
GUMBINER, CH ;
DANFORD, DA .
JOURNAL OF PEDIATRICS, 1989, 115 (04) :549-553
[8]  
LEV M, 1953, AUTOPSY DIAGNOSIS CO, P38
[9]   TRANSCATHETER CLOSURE OF ATRIAL SEPTAL-DEFECTS - EXPERIMENTAL STUDIES [J].
LOCK, JE ;
ROME, JJ ;
DAVIS, R ;
VANPRAAGH, S ;
PERRY, SB ;
VANPRAAGH, R ;
KEANE, JF .
CIRCULATION, 1989, 79 (05) :1091-1099
[10]   INTERVENTIONAL CATHETERIZATION IN PEDIATRIC CONGENITAL AND ACQUIRED HEART-DISEASE [J].
PERRY, SB ;
KEANE, JF ;
LOCK, JE .
AMERICAN JOURNAL OF CARDIOLOGY, 1988, 61 (14) :G109-G117