摘要
目的:评价经胸小切口封堵术治疗室间隔缺损的临床疗效和安全性。方法:2007年3月～2010年3月食管超声引导下完成56例经胸小切口封堵术。胸骨下段3～5 cm切口暴露右室流出道,于震颤最明显处缝两个荷包,将输送装置刺入右室流出道,在超声引导下经过室间隔缺损,释放大于室间隔缺损直径3～4 mm的封堵器,食管超声评估封堵器的位置、对房室瓣和主动脉瓣的影响以及有无残余分流。结果:56例患者中55例封堵成功,1例转体外循环手术,共置入56只封堵器,安置封堵器时间平均30 m in。1例手术后3天出现一过性房室传导阻滞,激素冲击疗法后治愈出院。所有病例随访3～6个月,无残余分流、无心律失常、无主动脉瓣和房室瓣返流。结论:经胸小切口封堵术易于操作、疗效确切、安全可靠。
Objective：To evaluate the efficacy and safety of mini-incision transthoracic occlusion of VSD.Methods：In 56 cases mini-incision transthoracic occlusion of VSD was conducted under the guidance of transesophageal echocardiography from March 2007 to March 2010 in this hospital.An incision 3～5 cm in length was made in the lower part of sternum to expose the right ventricle outlet,at which 2 purse-string sutures was placed.A delivery catheter was punctured into the right ventricle through the purse,and passed through the defect into the left ventricle under the guidance of transesophageal echocardiography.An occluder 3～4 mm larger than the VSD was released to engage on the defect.The delivery catheter was then withdrawn.The evaluation was made under the transesophageal echocardiography.Result：55 cases had successful occlusions with 56 occluders.1 case was operated under extracorporeal circulation.The mean time of delivery of occluder was 30 minutes.High degree atrioventricular block occured in 1 case 3 days after operation and was cured with large dose glucocorticoid.On a follow up of 3～6 months,no residual shunt,no tricuspid regurgitation,no aortic valve regurgitation was found.Conclusion：Mini-incision transthoracic occlusion of VSD is safe,reliable and easy to handle.
出处
《赣南医学院学报》
2011年第4期543-544,共2页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
关键词
经胸小切口
封堵器
室间隔缺损
transthoracic mini-incision
Occluder
ventricular septal defect
