摘要
目的:探讨嵴内型室间隔缺损介入治疗适应证选择,并评价其近期疗效。方法:2004年3月至2005年11月,采用国产新型零偏心室间隔缺损(VSD)封堵器对49例嵴内型VSD患者进行封堵治疗,其中男25例,女24例,年龄2．5～15(6．2±3．6)岁。经胸超声心动图显示VSD的直径2～10(5．2±2．3)mm。所有患者在透视及超声监测下通过建立股动静脉轨道,经右心系统释放封堵器,并分别于术后1、3、6、12个月通过经胸超声心动图检查、12导联心电图检查等,从残余分流、瓣膜功能、心功能、心电图及封堵器直径变化率5方面进行随访评价。结果:45例患者封堵器置入成功,技术成功率91．8％。4例未成功者分别为:3例为伴有主动脉瓣脱垂者,1例为超声判断误差。42例患者接受了1～12(平均8．6)个月的随访,所有随访病例中,无新增加的三尖瓣关闭不全,无主动脉瓣穿孔,2例出现少量主动脉瓣反流者,其中1例为封堵器出现微移位。无其他严重并发症发生。封堵器置入即刻及术后6个月,左心室舒张末径发生进行性缩小,而右心室舒张末前后径及射血分数未见明显变化。封堵器置入24 h,封堵器腰部直径较置入即刻发生轻微变化,术后1、3、6、12个月随访无明显变化。结论:缺损直径在10 mm以内且无病理性主动脉反流的嵴内型VSD可以选择介入治疗,其近期效果良好。
Objective ： To investigate indications of transcatheter closure of intracristal ventricular septal defects （VSD） and evaluate its short-term efficacy.
Methods：From March 2004 to November 2005,49 patients （25 males,24 females） with intracristal VSD underwent catheter closure with a new type device specially designed for intracristal VSD, The mean age of patients was 6. 2 ± 3.6 years （ range 2. 5 to 15 years） ; the mean diameter of VSD measured by transthoracic echocardiography （TILE） was 5.2 ± 2. 3 mm （range 2 to 10 ram）. Occluder was released through right heart system. After procedures,in order to evaluate the residual shunt, valve function,heart function, eletrocardiographic findings and the variety rate of occluder waist diameter, follow-up was made with TTE and echocardiography at 1,3,6 and 12 months after procedures. Results ：The devices were deployed successfully in 45 patients（ the successful rate was 91.8% ）. Of 4 unsuccessful cases,3 were complicated with right coronary valveprolapse and 1 mistakenly judged by TTE. During the period of follow-up （ 1-12 months, mean g. 6 months ） ,no tricuspid regurgitation or aortic valve perforation in 42. The occluder was trivial by displaced in one of two cases which had light aortic regurgitation. Left ventricular end-diastolic diameter was shrinked gradually during 6- month follow-up while right ventricular end-diastolic diameter and ejection fraction had no obvious change. Occluder＇ s waist diameter had slight change 24 hours after procedures,but no obvious change at 1,3,6 and 12 months after procedures. Conclusion：Intracristal VSD with a diameter ≤ 10 mm without aortic regurgitation may be closured by transcatheterization with a good short-term results.
出处
《中国循环杂志》
CSCD
北大核心
2006年第5期368-371,共4页
Chinese Circulation Journal
关键词
室间隔缺损
介入治疗
Heart septal defects,ventricular
Heart transcatheterization
