经导管室间隔穿孔封堵术的临床效果Clinical outcome of transcatheter closure of postinfarction ventricular septal rupture
张端珍,朱鲜阳,韩雅玲,崔春生,王琦光,陈火元
摘要(Abstract)：
目的探讨经导管封堵术治疗心肌梗死(myocardial infarction,MI)后室间隔穿孔(ventricular septal rupture,VSR)的可行性和安全性。方法纳入2008年1月至2014年12月,37例急性MI后VSR实施经导管VSR封堵术的患者,所有操作均于MI 3周后进行,术后定期随访。结果VSR封堵术于MI后41(21,99)d实施,22例(59.5%,22/37)患者术前行主动脉内球囊反搏术。因造影显示多发缺损不适于封堵术和冠状动脉多支病变不适于经皮冠状动脉介入治疗而排除2例(5.4%,2/37)。共对35例患者实施封堵术,32例(91.4%,32/35)成功置入封堵器。VSR右心室面直径(13.0±3.0)mm,置入封堵器直径(22.0±3.0)mm,术后即刻造影示完全关闭15例(46.9%,15/32),少量残余分流15例(46.9%,15/32),中度残余分流2例(6.2%,2/32)。围术期死亡3例(8.6%,3/35),2例(5.7%,2/35)因并发症而行外科手术,最终成功28例(80.0%,28/35)。随访3.5年(3个月,7年),失访3例(10.7%,3/28),死亡3例(10.7%,3/28)。结论经导管VSR封堵术安全可行,可作为外科手术替代方案。
关键词(KeyWords)： 冠心病;心肌梗死;室间隔穿孔;经皮冠状动脉介入治疗
基金项目(Foundation):
作者(Author): 张端珍,朱鲜阳,韩雅玲,崔春生,王琦光,陈火元
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