目的 分析单纯经导管介入封堵治疗儿童动脉导管未闭（PDA）合并中、重度二尖瓣反流（MR）的中长期疗效,探究其安全性及可行性。方法 回顾 2013年3月至2019年3月诊断PDA合并中、重度MR并单纯行经导管介入封堵治疗患儿的临床资料。结果 共纳入121例患儿,男27例、女94例,年龄19.8（8.0~28.0）月;合并中度MR 94例,重度MR 27例。超声下PDA直径（6.4±1.8）mm。患儿术前,术后24 h,术后1、3、6、12、24月的主肺动脉（MPA）直径、左心房（LA）直径、左心室舒张末期直径（LVEDD）、左心室收缩末期直径（LVESD）差异均有统计学意义（P<0.05）。与术前相比,术后各随访时间点MPA直径、LA直径、LVEDD和LVESD均缩短,差异有统计学意义（P<0.05）。随访期间120例（93.4%）患儿MR程度较术前减轻。所有患儿术前,术后24 h,术后1、3、6、12及24月的MR面积差异有统计学意义（P<0.05）,术后各随访时间点MR面积均较术前缩小,差异有统计学意义（P<0.05）,但术后12与24个月之间MR面积差异无统计学意义（P>0.05）。结论 PDA合并中、重度MR患儿在严格把握手术指征的前提下,单纯行经导管介入封堵治疗可改善MR程度、降低左心负荷,该方法安全有效。

Objective To analyze the medium - and long-term efficacy of simple transcatheter closure in the treatment of children with patent ductus arteriosus (PDA) complicated with moderate and severe mitral regurgitation (MR), and to explore its safety and feasibility. Methods Clinical data of children diagnosed with PDA complicated with moderate and severe MR and treated with transcatheter closure from March 2013 to March 2019 were retrospectively analyzed. Results A total of 121 children (27 boys and 94 girls) with a median age of 19.8 (8.0-28.0) months were included. There were 94 cases with moderate MR and 27 cases with severe MR. Echocardiography showed that the diameter of PDA was (6.4±1.8) mm. There were statistically significant differences in the main pulmonary artery (MPA) diameter, left atrium (LA) diameter, left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) among different time points (preoperative, postoperative 24 h, postoperative 1, 3, 6, 12 and 24 months) (P<0.05). Compared with pre-operation, MPA diameter, LA diameter, LVEDD and LVESD were all shortened at each follow-up time point after surgery, with statistical significance (P<0.05). During the follow-up period, 120 children (93.4%) had less MR than pre-operation. There were statistically significant differences in MR areas of all children among different time points (preoperative, postoperative 24 h, postoperative 1, 3, 6, 12 and 24 months) (P<0.05). The postoperative MR area at each follow-up time point was significantly smaller than that before surgery (P<0.05), but there was no significant difference in MR area between 12 and 24 months after surgery (P>0.05). Conclusions On the premise of strictly grasping the surgical indications, simple transcatheter closure can improve MR degree and reduce left heart load in PDA combined with moderate and severe MR in children, which is safe and effective.