外科手术治疗房室间隔缺损介入治疗严重并发症16例分析Cause and surgical treatment of severe complications of atrial septal defect (ASD) and ventricular septal defect (VSD) after unsuccessful interventional treatment
韩宏光,张南滨,汪曾炜,王辉山,朱洪玉,李新民
摘要(Abstract)：
目的探讨房室间隔缺损介入治疗后严重并发症发生的原因及外科手术,以提高手术的成功率。方法选择2000年1月至2007年12月在沈阳军区总医院接受经导管介入治疗房间隔缺损(ASD)和室间隔缺损(VSD)失败后,需再行外科手术的16例病例进行回顾性分析。外科手术指征为封堵器脱落7例、心脏穿孔3例、Ⅲ度房室传导阻滞(AVB)3例、瓣膜关闭不全2例(其中1例同时合并Ⅲ度AVB)、残余漏1例、封堵失败1例。手术均在体外循环下进行,取出封堵器,修复心内畸形,术后入ICU监护。结果ASD介入治疗患者中,手术探查ASD直径平均31mm,较术前诊断的平均26mm增大。ASD部位为中央型5例,下腔型7例,与术前诊断相符率41.7%,不相符率58.3%。3例Ⅲ度AVB者术后均恢复窦性心律。心内畸形修复完善,无手术死亡。结论房室间隔缺损介入治疗后严重并发症发症应引起高度重视,及时采取外科手术治疗,效果良好,安全可靠,避免治疗失败及术后并发症的发生。
关键词(KeyWords)： 房间隔缺损;室间隔缺损;介入封堵;并发症
基金项目(Foundation):
作者(Author): 韩宏光,张南滨,汪曾炜,王辉山,朱洪玉,李新民
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