Efficacy and safety of ultrasound-guided percutaneous retrograde closure of patent ductus arteriosus_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUN Bao ,  CHENG Duan , LI Bo , HE Guibao , WANG Haifeng , Ahati , Elias , SHENG Xi , LI Jinpeng , Sadam· Hussain

Department of Cardiac Surgey, Xinjiang Cardiac and Neurovascular Disease Hospital,Urumqi, 830011, P.R.China;

Corresponding?author：

CHENG Duan, Email: chengduan@126.com

Keywords：

Ductus arterious; femoral artery; transthoracic echocardiography; occluder

DOI：

10.7507/1007-4848.201903025

Video：

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Objective To evaluate the efficacy and safety of transcatheter closure of patent ductus arteriosus (PDA) with transthoracic echocardiography (TTE).Methods From February 2016 to November 2018, 98 patients of pure PDA were selected, including 43 patients of funnel type and 55 patients of tube type. There were 38 males and 60 females at age of 2-48 (9.8±10.4) years. All patients underwent TTE-guided retrograde closure of the PDA through the femoral artery to establish a femoral-abdominal aorta-thoracic aorta-ductus arteriosus-aorta-right ventricle trajectory.Under the guidance of TTE, a suitable closure umbrella was placed through the femoral artery. One month, 3 months, 6 months, 12 months after the surgery, the patients received out-patient clinical follow-up.Results Ninety eight patients were successfully occluded by TTE. The occluder was replaced many times in an adult PDA patient, but finally it was successfully plugged. The operation time was 33.2±5.8 min. The lumbar diameter was 12±6 mm. And the postoperative murmur disappeared. Ultrasound showed no shunt between the aorta and the pulmonary artery, and the postoperative hospital stay was 3-4 days. No shunt signal was found in 1, 3, 6, 12 months follow-up. Left atrial anteroposterior diameter (25.8±6.1 mm vs. 30.6±8.4 mm) and left ventricular end diastolic diameter (38.5±9.1 mm vs. 45.2±11.5 mm) were significantly smaller (P < 0.05).Conclusion TTE-guided transcatheter closure of PDA via femoral artery is a safe and effective method to avoid the damage of X-ray and contrast medium. The prospect of clinical application is good.

Citation： SUN Bao, CHENG Duan, LI Bo, HE Guibao, WANG Haifeng, Ahati, Elias, SHENG Xi, LI Jinpeng, Sadam· Hussain. Efficacy and safety of ultrasound-guided percutaneous retrograde closure of patent ductus arteriosus. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1208-1212. doi: 10.7507/1007-4848.201903025 Copy

1.	Bixler GM, Powers GC, Clark RH, et al. Changes in the diagnosis and management of patent ductus arteriosus from 2006 to 2015 in United States neonatal intensive care units. J Pediatr, 2017, 189: 105-112.
2.	Baruteau AE, Hascoet S, BaruteauJ, et al. Transcatheter closure of patent duceus arteriosus: past present and future. Arch Cardiovasc Dis, 2014, 107(2): 122-132.
3.	Zanhn EM, Peck D, Phillips A, et al. Transcatheter closure of patent ductus arteriosus in extremely premature newborns: early results and midterm follow-up. ACC Cardiovasc Interv, 2016, 9(23): 2429-2437.
4.	Meinel FG, Nance JW Jr, Harris BS, et al. Radiation risks from cardiovascular imaging tests. Circulation, 2014, 130(5): 442-445.
5.	Balter S, Miller DL. Patient skin reactions from interventional fluoroscopy procedures. AJR Am J Roentgeol, 2014, 202(4): W335-342.
6.	Maioli M, Toso A, Leoncini M, et al. Persistent renal damage after contrast-induced acute kidney injury: incidence, evolution, riskfactors, and prognosis. Circulation, 2012, 125(25): 3099-3107.
7.	Pan XB, Ouyang WB, Wang SZ, et al. Transthroacic echocardiography gudied percutaneous patent. Echocardiography, 2016, 33(7): 1040-1045.
8.	潘湘斌, 逢坤靜, 歐陽文斌, 等. 單純超聲心動圖引導經皮室間隔缺損封堵術的應用研究. 中國循環雜志, 2015, 30(8): 774-776.
9.	謝涌泉, 趙廣智, 李慕子, 等. 單純超聲心動圖引導下經皮球囊主動脈瓣成形術治療先天性主動脈瓣狹窄的中期結果. 中國胸心血管外科臨床雜志, 2018, 25(10): 829-833.
10.	Philip R, Waller BR 3rd, Agrawal V, et al. Morphologic characterization of the patent ductus arteriosus in the premature infant and the choice of transcatheter occlusion device. Catheter Cardiovasc Interv, 2016, 87(2): 310-317.
11.	Thanoplulos BV, Ninios V, Dardas P, et al. Catheter closure through a venous approach of patent ductus arteriosus in small pediatric, patients using combined angiographic and echocardiographic guidance. Am J Cardiol, 2016, 118(10): 1558-1562.
12.	Roguin A, Goldstein J, Bar O, et al. Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol, 2013, 111(9): 1368-1372.
13.	逢坤靜, 王浩, 孟紅, 等. 經胸二維超聲心動圖引導兒童房間隔缺損經皮封堵治療. 中華超聲影像學雜志, 2014, 23(7): 573-576.
14.	Trefz M, Wilson N, Acton R, et al. Echocardiographic assessment of duetal anatomy in premature infants lessons for device design. Echocardiography, 2010, 27(5): 575-579.
15.	張玉順, 張軍, 李寰, 等. 超聲心動圖在介入治療動脈導管未閉中作用的再評估. 中國超聲醫學雜志, 2002, 18: 685-687.
16.	Chang YP, Chan SW, Chai JW, et al. Pulmonary hypertension and right ventricular dysfunction in patients with left to right shunt coronary artery fistula: evaluation with cardiac CT. Int J Cardiovasc Imaging, 2016, 32(suppl): 91-104.
17.	徐建新, 周紹斌, 金洪來, 等. CT三維成像指導動脈導管未閉介入封堵術臨床價值. 介入放射學雜志, 2017, 26(3): 206-209.
18.	吉煒, 李奮, 高偉, 等. 第二代 Amplatzer 動脈導管未閉封堵器介入治療動脈導管未閉的臨床研究. 中華兒科雜志, 2013, 51(2): 126-129.

1. Bixler GM, Powers GC, Clark RH, et al. Changes in the diagnosis and management of patent ductus arteriosus from 2006 to 2015 in United States neonatal intensive care units. J Pediatr, 2017, 189: 105-112.
2. Baruteau AE, Hascoet S, BaruteauJ, et al. Transcatheter closure of patent duceus arteriosus: past present and future. Arch Cardiovasc Dis, 2014, 107(2): 122-132.
3. Zanhn EM, Peck D, Phillips A, et al. Transcatheter closure of patent ductus arteriosus in extremely premature newborns: early results and midterm follow-up. ACC Cardiovasc Interv, 2016, 9(23): 2429-2437.
4. Meinel FG, Nance JW Jr, Harris BS, et al. Radiation risks from cardiovascular imaging tests. Circulation, 2014, 130(5): 442-445.
5. Balter S, Miller DL. Patient skin reactions from interventional fluoroscopy procedures. AJR Am J Roentgeol, 2014, 202(4): W335-342.
6. Maioli M, Toso A, Leoncini M, et al. Persistent renal damage after contrast-induced acute kidney injury: incidence, evolution, riskfactors, and prognosis. Circulation, 2012, 125(25): 3099-3107.
7. Pan XB, Ouyang WB, Wang SZ, et al. Transthroacic echocardiography gudied percutaneous patent. Echocardiography, 2016, 33(7): 1040-1045.
8. 潘湘斌, 逢坤靜, 歐陽文斌, 等. 單純超聲心動圖引導經皮室間隔缺損封堵術的應用研究. 中國循環雜志, 2015, 30(8): 774-776.
9. 謝涌泉, 趙廣智, 李慕子, 等. 單純超聲心動圖引導下經皮球囊主動脈瓣成形術治療先天性主動脈瓣狹窄的中期結果. 中國胸心血管外科臨床雜志, 2018, 25(10): 829-833.
10. Philip R, Waller BR 3rd, Agrawal V, et al. Morphologic characterization of the patent ductus arteriosus in the premature infant and the choice of transcatheter occlusion device. Catheter Cardiovasc Interv, 2016, 87(2): 310-317.
11. Thanoplulos BV, Ninios V, Dardas P, et al. Catheter closure through a venous approach of patent ductus arteriosus in small pediatric, patients using combined angiographic and echocardiographic guidance. Am J Cardiol, 2016, 118(10): 1558-1562.
12. Roguin A, Goldstein J, Bar O, et al. Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol, 2013, 111(9): 1368-1372.
13. 逢坤靜, 王浩, 孟紅, 等. 經胸二維超聲心動圖引導兒童房間隔缺損經皮封堵治療. 中華超聲影像學雜志, 2014, 23(7): 573-576.
14. Trefz M, Wilson N, Acton R, et al. Echocardiographic assessment of duetal anatomy in premature infants lessons for device design. Echocardiography, 2010, 27(5): 575-579.
15. 張玉順, 張軍, 李寰, 等. 超聲心動圖在介入治療動脈導管未閉中作用的再評估. 中國超聲醫學雜志, 2002, 18: 685-687.
16. Chang YP, Chan SW, Chai JW, et al. Pulmonary hypertension and right ventricular dysfunction in patients with left to right shunt coronary artery fistula: evaluation with cardiac CT. Int J Cardiovasc Imaging, 2016, 32(suppl): 91-104.
17. 徐建新, 周紹斌, 金洪來, 等. CT三維成像指導動脈導管未閉介入封堵術臨床價值. 介入放射學雜志, 2017, 26(3): 206-209.
18. 吉煒, 李奮, 高偉, 等. 第二代 Amplatzer 動脈導管未閉封堵器介入治療動脈導管未閉的臨床研究. 中華兒科雜志, 2013, 51(2): 126-129.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Efficacy and safety of ultrasound-guided percutaneous retrograde closure of patent ductus arteriosus

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