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目的:研究动脉导管未闭(PDA)的血管造影分型,探讨其在介入治疗中的价值。方法:2002-01-2008-03期间120例PDA患者于封堵术前施行了主动脉弓降部造影术,年龄2～70(16±2.5)岁,120例患者采用左侧位造影,其中9例患者加摄右前斜20°～50°体位,2例患者加摄左前斜70°～85°体位。将造影结果根据PDA形态及其与主动脉弓降部的夹角进行分型。结果:①根据PDA形态将PDA分为5种类型,漏斗型92例,最窄直径2～13.9mm,平均最窄直径(4.0±3.0)mm;管型16例,平均直径为(6.1±1.3)mm;哑铃型2例,最窄直径分别为2.4、8.0mm;指型5例,最窄直径为(2.4～5.8)mm,平均最窄直径为(3.2±1.1)mm;半漏斗型5例最窄直径2.1～5.6cm,平均最窄直径为(3.5±0.8)mm。②根据PDA与降主动脉的夹角将PDA分为成角型PDA15例及非成角型PDA105例。③封堵器选择:其中98例患者选择标准型Amplatzer导管封堵器、15例患者选择成角型Amplatze导管封堵器、5例选择偏心型导管封堵器。2例选择肌部室间隔缺损Amplatze导管封堵器。④手术成功率及随访结果:手术成功率100%,术后随访6个月无残余分流、封堵器移位及脱落。结论:PDA形态变化多端,PDA长轴与降主动脉夹角不一,认识PDA类型有助于指导介入封堵治疗。
Objective: To study the angiographic classification of patent ductus arteriosus (PDA) and explore its value in interventional therapy. Methods: From January 2002 to February 2008, 120 patients with PDA underwent aortic arch angiography (range, 2 to 70 years (range: 16 ± 2.5) years). The left side of 120 patients underwent angiography. Nine patients Patients plus right front oblique 20 ° ~ 50 ° position, 2 patients plus left anterior oblique 70 ° ~ 85 ° position. The imaging results based on the morphology of PDA and its descending aorta bow angle classification. The PDA was divided into five types according to PDA morphology. 92 cases were funnel, the narrowest diameter was 2 ~ 13.9mm, the average narrowest diameter was 4.0 ± 3.0mm. The diameter of the tube was (6.1 ± 1.3) ) mm; dumbbell type in 2 cases, the narrowest diameter was 2.4,8.0mm; finger type in 5 cases, the narrowest diameter of (2.4 ~ 5.8) mm, the average narrowest diameter of (3.2 ± 1.1) mm; The narrowest diameter of 2.1 to 5.6cm, the average diameter of the narrowest (3.5 ± 0.8) mm. According to the angle between PDA and descending aorta, PDA was divided into 15 cases of angled PDA and 105 cases of non-angled PDA. ③ occluder selection: 98 patients selected standard Amplatzer catheter occluder, 15 patients selected angled Amplatze catheter occluder, 5 patients choose eccentric catheter occluder. 2 cases of muscular septal defect Amplatze catheter occluder. ④ Surgical success rate and follow-up results: The success rate of surgery was 100%. There was no residual shunt after 6 months of follow-up. The occluder shifted and fell off. Conclusion: PDA morphological changes, PDA long axis and descending aorta different angle, recognizing the PDA type will help guide the interventional closure therapy.