经导管置入Amplatzer封堵器治疗多孔的房间隔缺损及其初步疗效评价Transcatheter closure of multiple secundum atrial septal defects using Amplatzer septal occluder: a preliminary result of clinical application
徐仲英,徐立,戴汝平,张戈军,刘延玲,朱振辉,金敬琳,蒋世良
摘要(Abstract):
目的 经导管置入Amplatzer封堵器治疗多孔的继发孔型房间隔缺损 (ASD) ,并对其疗效进行初步评价。方法 8例多孔ASD病人 ,男性 1例 ,女性 7例 ,年龄 11~ 5 6岁 (36 6± 17 3)岁 ,体重 2 8~ 90 (6 0 1± 19 5kg)。所有病例均于X线透视和术中超声心动图监测下置入一个Amplatzer封堵器同时闭合大小缺损。术后重复TTE、ECG及X线平片检查以评价疗效。结果 8例患者封堵器置入均获成功。除 1例术中发生短暂性ST段抬高外 ,无其他严重并发症。早期 4例根据球囊测量值选择封堵器 ,余 4例根据TEE测量值选择封堵器 ,采用封堵器直径为 13~ 34 (2 2 4± 7 0mm)。术后即刻TEE/TTE检查显示 8例患者大缺损均获完全闭合 ,但有 5例 (6 2 5 % )患者其小缺损存在微量到少量残余分流。术后 2 4h复查提示 3例 (37 5 % )仍存在少量分流。近期随访中TTE检查发现 2例 (2 5 % )患者仍存在少量残余分流 ,但同期TTE检查提示其右心室舒张末径 (RVEDD)均较术前明显回缩 ,基本恢复正常水平。结论 经导管置入Amplatzer封堵器治疗多孔的ASD是一安全有效的方法 ,近期疗效满意 ,中远期疗效尚需进一步观察。
关键词(KeyWords): 房间隔缺损;心导管术
基金项目(Foundation):
作者(Author): 徐仲英,徐立,戴汝平,张戈军,刘延玲,朱振辉,金敬琳,蒋世良
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