王森,刘威,蒋鹤,张毅刚,刘茹,阮宏云

• 1:东南大学附属徐州市中心医院心内科
• 2:东南大学附属徐州市中心医院超声科

摘要(Abstract)：

膜部瘤型室间隔缺损是指在室间隔膜部缺损的基础上，由于血流长期冲击或组织增生，在缺损的右心室侧形成的一个囊袋状或瘤样突出结构。因瘤体形态复杂、出口多变且内部支撑力差，常规导丝导管难以建立稳定输送轨道。本病例报道1例13岁男性患儿，诊断为膜部瘤型室间隔缺损。瘤体内操作空间狭小，导管易反向弹出，故术中采用Runthrough导丝先行通过缺损作为后续导丝的“引路人”，联合并行0.032 in超滑导丝构建双导丝轨道以显著增强支撑力；在目标出口轨道建立困难时，应用“预封堵次要出口”策略以增加瘤体支撑力，辅助完成精准封堵。术后造影及超声证实无残余分流，未发生主动脉瓣或三尖瓣反流，动态心电图未见房室传导阻滞。术后1个月复查超声心动图提示封堵器固定良好，无残余分流，心电图未见传导阻滞。本病例提示，双导丝技术与预封堵策略的联合应用可有效解决复杂膜部瘤型室间隔缺损的轨道建立难题，提高介入手术成功率。

关键词(KeyWords)： 膜部瘤型室间隔缺损;双导丝技术;预封堵策略

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王森,刘威,蒋鹤,张毅刚,刘茹,阮宏云

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