双pda封堵器治疗冠状动脉瘘合并巨大冠状动脉瘤成功（附2例报告）

精品文档2016全新精品资料全新公文范文全程指导写作独家原创1/5双PDA封堵器治疗冠状动脉瘘合并巨大冠状动脉瘤成功（附2例报告）作者郑宏,兰天,徐争鸣,刘明,吴文辉,吕滨,张岩,李世国,徐丽丽,蒋世良,赵世华,徐仲英,凌坚,孙鑫【摘要】目的报告并讨论采用双PDA封堵器堵闭冠状动脉瘘合并巨大冠状动脉瘤成功经验。方法对2例冠状动脉瘘合并巨大冠状动脉瘤患者采用股动脉升主动脉冠状动脉冠状动脉瘘右房下腔静脉股静脉轨道法，经股静脉分别将14F及12F输送鞘送至冠状动脉瘤的两端并各置入2枚国产PDA封堵器（1例为20/18和18/16MM，另1例置入2枚22/20MM）施行冠状动脉瘘堵闭术。结果第1枚封堵器置入后造影显示经冠状动脉瘘左向右分流明显减少，第二枚封堵器置入后分流基本消失。封堵术后第一例肺动脉压由50/24（34）降至26/9（17）MMHG，第二例由60/26（37）降至35/15（18）MMHG。术后第二天超声复查显示分流完全消失。分别随访41及19个月，患者情况良好，体征消失，症状明显改善。结论采用双PDA封堵器堵闭冠状动脉瘘合并巨大冠状动脉瘤2例取得良好效果，可作为该畸形替代外科手术治疗的一种方法。精品文档2016全新精品资料全新公文范文全程指导写作独家原创2/5【关键词】冠状动脉瘘冠状动脉瘤国产封堵器封堵术SUCCESSFULTRANSCATHETERCLOSUREOFCONGENITALCORONARYARTERYFISTULACOMPLICATEDWITHAGIANTCORONARYARTERYANEURYSMBYUTILIZATIONOFDOUBLECHINESEHOMEMADEPDAOCCLUDERSREPORTOFTWOCASESZHENGHONG,LANTIAN,XUZHENGMING,ETOFRADIOLOGY,CARDIOVASCULARINSTITUTEANDFUWAIHOSPITAL,CAMSANDPUMC,BEIJING100037,CHINAABSTRACTOBJECTIVETODESCRIBEOUREXPERIENCEWITHTRANSCATHETEROCCLUSIONOFCONGENITALCORONARYARTERIALFISTULASCOMPLICATEDWITHAGIANTCORONARYARTERYANEURYSMBYUTILIZATIONOFDOUBLECHINESEHOMEMADEPDATWOSYMPTOMATICPATIENTS,ONEMANAGED36ANDONEWOMANAGED56YEARSOLDUNDERWENTTRANSCATHETEROCCLUSIONOFBOTHFISTULASANDGIANTCORONARYARTERYANEURYSMATSAMEPROCEDURESBYUTILIZATIONOFDOUBLECHINESEHOMEMADEPDAOCCLUDERSALLTWOPATIENTSHADCHESTDISTRESSANDDYSPNEAONEXERTIONTHEFISTULAORIGINATEDFROMTHELEFTCIRCUMFLEXARTERY（LCX）TOCORONARYSINUSINMANANDFROMLCXINTO精品文档2016全新精品资料全新公文范文全程指导写作独家原创3/5RIGHTATRIUMINWOMANANDBOTHCOMPLICATEDWITHAGIANTCORONARYARTERYANEURYSMNEARBYREMOTEEND,THEDIAMETEROFANEURYSMWERE36AND39MMRESPECTIVELYTWOCHINESEHOMEMADEPDAOCCLUDERS,WHICHWERETWOOFTHETYPEOF22/20MMINMANANDTWOOFTHETYPEOF20/18AND18/16MMINWOMAN,WEREDEPLOYEDINTOTHECORONARYARTERIESTOOCCLUDETHEOPENINGOFTHEANEURYSMANDTHEENDOFTHEFISTULASONEAFTERANOTHERINBOTHPATIENTSTHROUGHA14FAND12FDELIVERTHEPROCEDURESWEREUNCOMPLICATEDANDSUCCESSFULTWOPATIENTSWEREFOLLOWEDUPAFTER41AND19MONTHSANDUNDERWENTEXAMINATIONOFUCGANDCHESTFILMTOSHOWTHATTHELEFTTORIGHTSHUNTWEREDISAPPEAREDANDCARDIOTHORACICRATIOWASSMALLERTHECHESTDISTRESSANDDYSPNEASOFTHESETWOPATIENTSHAVEALSORESOLVEDAFTERTHETRANSCATHETERCLOSUREOFCONGENITALCORONARYFISTULASCOMPLICATEDWITHAGIANTCORONARYARTERYANEURYSMBYUTILIZATIONOFDOUBLECHINESEHOMEMADEPDAOCCLUDERSARESAFEANDEFFECTIVE,ANDCANBEREGARDEDASANACCEPTABLEALTERNATIVETOSURGERY精品文档2016全新精品资料全新公文范文全程指导写作独家原创4/5KEYWORDSCORONARYARTERYFISTULACORONARYARTERYANEURYSMSCHINESEHOMEMADESEPTALOCCLUDEROCCLUSION介入治疗冠状动脉瘘（CAF）的报道日渐增多，已被越来越多的医生和学者所接受，过去报道的多采用弹簧圈和单个先心病封堵器进行封堵，而采用双PDA封堵器治疗冠状动脉瘘合并巨大冠状动脉瘤者尚未见报道。现就我院采用国产双PDA封堵器对冠状动脉瘘合并巨大冠状动脉瘤治疗成功的经验报道如下。1临床资料病例1女，56岁，发现心脏杂音30余年，平素活动可，但活动量大，上四楼时感心慌、气短、胸闷。查体胸骨左缘23肋间可闻及/6级双期杂音及心尖部/6级收缩期杂音，无震颤，A2【参考文献】1朱晓东，张宝仁心脏外科学北京人民卫生出版社，20075442MEYERJ，REULGI，MULLINSCE，ETALCONGENITALFISTULAEOFTHECORONARYARTERIESCLINICALCONSIDERATIONSANDSURGICALMANGEMENTIN23PATIENTSJTHORACCARDIOVASCSURG,1975，16（1）506510精品文档2016全新精品资料全新公文范文全程指导写作独家原创5/53COLLINSN，MEHTAR，BENSONL，ETALPERCUTANEOUSCORONARYARTERYFISTULACLOSUREINADULTSTECHNICALANDPROCEDURALASPECTSCATHETERCARDIOVASCINTERV2007，69（6）8728804KRABILLKA，HUNTERDWTRANSCATHETERCLOSUREOFCONGENITALCORONARYARTERIALFISTULAWITHADETACHABLEBALLOONPEDIATRCARD