Feasibility and efficacy of transcatheter closure of anastomotic leakage after aortic surgery using Amplatzer Vascular Plug Ⅲ
10.3760/cma.j.issn.0253-3758.2018.03.007
- VernacularTitle: 应用第3代Amplatzer血管塞治疗主动脉病变外科手术后吻合口漏的可行性和有效性
- Author:
Wenhui WU
1
;
Lianjun HUANG
;
Junzhou PU
;
Xiaoyong HUANG
;
Xin PU
;
Yi NING
;
Xiao WANG
Author Information
1. Intervenional Department, Beijing Anzhen Hospital, Capital Medical University, Institute of Beijing Heart, Lung and Blood Vessel Diseases, Beijing 100029, China
- Publication Type:Clinical Trail
- Keywords:
Cardiovascular surgical procedures;
Anastomotic leakage;
Transcatheter closure
- From:
Chinese Journal of Cardiology
2018;46(3):203-207
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility and efficacy of transcatheter closure of anastomotic leakage after aortic surgery using Amplatzer Vascular Plug Ⅲ (AVP Ⅲ).
Methods:A retrospective analysis was performed in 5 patients with anastomotic leakage after aortic surgery, who underwent transcatheter closure in our hospital from January to June 2017 using AVP Ⅲ. Surgeries were performed in 3 cases of Standford type A dissection, 1 case of ascending aortic aneurysm and 1 case of persistent truncus.There were 3 males,and age was (43.8±13.1) years old. Anastomotic leakages located at the ascending aorta in 4 patients, and the other one located between the aortic arch and the stent-graft.Three of them had aorta-right atrium fistula and patients suffered from progressive heart failure. False aneurysm between aorta and pulmonary artery was formed in 1 patient, and patent aortic false lumenwas found in the other patient. All the AVP Ⅲ were deployed based on a femoral arteriosus loop. Patients were followed up after transcatheter closure to observe the clinical results.
Results:Six AVP Ⅲ were successfully implanted in the 5 patients. Trivial residual shunt was seen in 1 patient after closure. The patients were followed up 6 (1, 6) months. The cardiac function improved from NYHA class Ⅱ-Ⅳ to class Ⅰ-Ⅱ after the procedure in 3 congestive heart failure patients.The right atrium systolic pressure was significantly reduced after the procedure((8.7±1.8) mmHg (1 mmHg=0.133 kPa) vs. (24.3±2.3) mmHg, P=0.03). The diameter of the false aneurysm reduced in 1 patient after the procedure. Complete thrombosis formation of the thoracic false lumen was observed in 1 patient.
Conclusion:Transcatheter closure of anastomotic leakage after aortic surgery using AVP Ⅲ is feasible and effective according to our primary experience.
