Contrastive study on the efficacy and safety between transcatheter patent ductus arteriosus closure and mini-incision transthoracic occlusion in children / 中华实用儿科临床杂志

ABSTRACT

Objective To evaluate efficacy and safety of transcatheter patent ductus arteriosus(PDA) closure compared with mini-incision transthoracic occlusion in children.Methods The safety and complications of 175 patients who underwent transcatheter closure(transcatheter group) hospitalized in Department of Pediatrics,Linyi People's Hospital were analyzed,the ages ranging from 3 months to 14 years,and the material used was Chinese homemade occluder except for the spring coil.Compared with the 157 patients who underwent mini-incision transthoracic occlusion (mini-incision group) hospitalized in Department of Heart Surgery,Linyi People's Hospital from Jan.2009 to Nov.2013,the ages ranging from 5 months to 14 years,the material used was same as the transcatheter group.Acquired data was processed through statistics.Results One hundred and seventy-one of the 175 patients achieved success in the transcatheter group,technically success rate was 97.71％,there were 8 patients with complications,but no death,the occurrence rate of complications was 4.57％ ;however,137 of 157 patients achieved success in the mini-incision group,technically success rate was 87.26％,there were 21 patients with complications and 1 death,the occurrence rate of complications was 13.38％.Success rate of the transcatheter group was much higher than the mini-incision group(x2 =8.05,P ＜ 0.01),while complications of the transcatheter group was significantly less than the mini-incision group(x2 =13.48,P ＜ 0.01),and also the transcatheter group had less hemorrhage during operation,shorter operation time,shorter hospital stay and less hospital expenses compared with the mini-incision group [(0.021 ± 0.007) L vs (0.088 ± 0.027) L,(36.81± 7.19) minvs (88.65 ±27.92) min,(4.16±0.45) dvs (10.68 ±2.38) d,(27 943.6± 2754.1) RMBvs(35037.4±8659.2) RMB;t=29.23,22.19,33.44,18.47,allP＜0.01].Conclusions Transcatheter PDA closure in children is better than mini-incision transthoracic occlusion because of its higher efficacy and lower risk,so it is the first choice of treatment to the children with PDA.