Application of Amplatzer vascular Plug Ⅱ in pediatric coronary artery fistula patients treated with transcat-heter closure
10.3760/cma.j.issn.2095-428X.2016.13.011
- VernacularTitle:2代 Amplatzer 血管塞在经导管介入治疗儿童冠状动脉瘘中的应用
- Author:
Lijian ZHAO
;
Bo HAN
;
Jianjun ZHANG
;
Yingchun YI
;
Diandong JIANG
;
Jianli LYU
;
Jing WANG
- Publication Type:Journal Article
- Keywords:
Coronary artery fistula;
Transcatheter closure;
Plug;
Arotic regurgitation
- From:
Chinese Journal of Applied Clinical Pediatrics
2016;31(13):1001-1004
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and safety of transcatheter closure of coronary artery fistula (CAF)with Amplatzer vascular PlugⅡ(AVPⅡ)in pediatric patients.Methods Between June 2012 and October 2015,5 children aged 0.9 to 7.0 years old and weighted 10 to 21 kg with CAF were admitted to the Department of Pediatric Cardiology in Shandong Provincial Hospital Affiliated to Shandong University.Aortic root angiography was used first to confirm the origin,shape,branches,drainage and the diameter of the orifice of CAF by deploying the pigtail catheter.The AVPⅡwas retrogradely deployed into targeted artery through guiding catheter and aortic angiography was performed before releasing the plug.Results All the 5 children underwent transcatheter closure by AVPⅡsuccessful-ly.Two cases were involved with right coronary -right ventricular fistula,1 case of left anterior descending coronary -right ventricular fistula (residual fistula after surgical repair),and 1 case of left circumflex coronary -left atrial fistula. Four children had a single fistula,and 1 case had double fistulas.The diameter of the orifice ranged from 2.00 to 5.96 mm,and the selected occluders from 8 to 14 mm.The ratio of diameter of occluder to fistula orifice ranged from 2.3 to 3.4.All the patients were followed up for 4 to 44 months.Two patients developed instant minor and modera-te aortic re-gurgitation.No other complications such as thrombosis,embolization,residual shunt,arrhythmia,coronary dissection or perforation occurred.Conclusions Transcatheter closure of CAF by AVPⅡin pediatric patients is feasible and safe. Aortic regurgitation should be noted,especially during the procedure.
