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KMID : 0367219940110010051
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Sejong Medical Journal
1994 Volume.11 No. 1 p.51 ~ p.60
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Transcatheter Closure of Patent Ductus Arteriosus with Rashkind Umbrella Device
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김성호
배은정/심우섭/손세정/강이석/이홍재
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Abstract
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Nonsurgical procedures for closure of patent ductus arteriosus(PDA) were attempted in 52 patients with use of the Rashkind double umbrella occluder device between January 1992 and April 1994.
Patient age ranged from 9 months to 34 years(median 3.8 years) with 15 aged less than 2 years. Their weights ranged from 7㎏ to 74㎏(median 15㎏). The mean diameter of the PDA was 4.0㎜ with 3(6%) greater than 6㎜.
In 51 of 52 patients, the device was successfully implanted. Device embolization occured in two patients; one to a pulmonary artery retrieved by basket catheter and operated, the other to a descending aorta snared by Amplatz snare and
repositioned
in
the PDA. Mechanical hemolysis occured in two pateitns and treated by operation.
12㎜ occluder device was used in 23 patients, and 17㎜ occluder device in 29 patients. At the 3-month follow up study, 37% (17/46) of the patients had a small residual shunt ; this prevalence was 18% (4/22) in patients with 12㎜ device, and 54%
(16/24)
in those with 17㎜ device.
The narrowest diameter greater than 4㎜ was significantly associated with as increased prevalence of residual shunt during 3 month follow-up period (range of P<0.0001 to 0.05). complete closure of the PDA was achieved in 63% (29/46) at 3 months
follow-up study and 71% (15/21) at 6 months, meanwhile clinical closure rate (defined as disappearance of murmur ) was 87% (40/46) at 3 months, and 90%(19/21) at 6month.
Transcatheter occlusion of the PDA is a safe and effective alternative to surgical closure, and it would be preferable to operation, especially in those with smaller PDA.
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KEYWORD
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