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应用Amplatzer 封堵器治疗房间隔缺损疗效评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第6期
页码:
476-478
栏目:
先心病介入治疗
出版日期:
2001-11-01

文章信息/Info

Title:
Evaluation of treatment efficiency of transcatheter closure of secundum atrial septal defects using Amplatzer occluder device
作者:
张玉顺1;  贾国良1;  刘建平1;  代政学1;  李　寰1;  张　军1;  王晓敏1;  马晓涛2
第四军医大学西京医院心血管内科, 陕西西安710032; 2. 解放军西安518 医院
Author(s):
ZHANG Yu-shun1;  JIA Guo-liang1;  LIU jian-ping1; DAI Zheng-xue1; LI Huan1;  ZHANG Jun1; WANG Xiao-min1; MA Xiao-tao2
Departmetn of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an Shaanxi 710032, China; 2. Xi’an 518 Hospital, PLA
关键词:
房间隔缺损;  介入治疗
Keywords:
atrial septal defects;  transcatheter closure
分类号:
R541. 1
DOI:
-
文献标识码:
A
摘要:
目的 评价经导管置入Amplatzer 封堵器治疗继发孔型房间隔缺损(ASD) 的治疗效果。方法 全组67 例, 年龄2～ 59 (29 土15) 岁, 术前经食管超声心动图(TEE) 检查示ASD 直径5～ 34 (22 土7)mm。所有病例均在透视及TEE 监视下经导管置入Amplatzer 封堵器封堵ASD。3 例有大小紧邻的两个房间隔缺损存在, 采用较大封堵器, 一并封堵两个缺损。术后24 h, 1～ 3 月及1 年分别行经胸超声心动图(TTE)、心电图及X 线检查评价治疗效果。结果 67 例A SD 直径的球囊测量值为7～ 36 (22 土7)mm , 选择的封堵器直径为7～ 38 (24 土10)mm。67 例封堵器置入后均获得成功, 技术成功率为100% , 术中未发生任何重要并发症, 无急诊手术病例。术后即刻, TEE 或TTE 显示7 例(10% ) 存在微量至少量残余分流。术后24 h TTE 显示4 例(6% ) 存在微量至少量残余分流。术后1～ 3 月TTE 示仅1 例(2% ) 多发A SD 存在少量分流。X 线检查全部显示肺血减少, 右心房、右心室缩小。结论 经导管置入Amplatzer 封堵器治疗ASD 是一种有效的非手术方法, 具有操作简便、安全、技术成功率高及封堵效果好等优点, 适合于各年龄组继发孔型ASD 的介入治疗。
Abstract:
AIM To evaluate the treatment efficiency of transcatheter closure of secundum atrial septal defect (ASD) using Amplatzer occluder device. METHODS There were 67 patients. The age was 29±15 years (ranged from 2 to 59 years). The defected diameter of ASD was 22±7(ranged from 5 to 34) mm shown by transesophageal echocardiography (TEE) before in terventions. Three cases had double ASD. Each case was occluded using Amplatzer occluder device through the percutaneous procedure. The closure proccdure was guided by fluoroscopy and TEE or transthoracic echocardiography (TTE). TEE and TTE were performed immediately and TTE,ECG and X-ray examination were done 24 hours, 1～ 3 months and 1 year after the procedure to evaluate the efficiency. RESULTS The ballon stretched diameter of the ASDs was 22±7 mm (ranged from 7 to 36 mm ). The diameter of the occluder selected was 24±10 mm (ranged from 7 to 38 mm ). The success rate of placement of Amplatzer occluder was 100%. No complications occurred during the procedure, and no one needed for emergency surgery. Trivial to small residual shunts were found in 7 cases (10% ) immediately after the procedure, in 4 cases (6% ) 24 hour after operation. No residual shunts was found in 1～ 3 month follow-up exceptin 1 case (2 % ) with multiple ASD. X-ray reexam ination showed that pulmonary blood flow and heart size were improved. CONCLUSION Transcatheter closure of secundum ASD using Amplatzer occluder device was an efficient for non surgical method for patients of any group. It had a high successful rate of technique and satisfied immediate and short term results.

参考文献/References

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[7] 戴汝平, 刘延玲, 张戈军, 等. 应用Amplatzer 封堵器介入治疗房间隔缺损疗效评价(附60 例报告) [J]. 中华心血管病杂志2000, 28: 87- 92.

[8] Thanopoulos BD, Laskari CV , Tsaousis GS, et al. Closure of atrial septal defects with Amplazer occlusion device: priminary results[J]. J Am Coll Cardiol, 1998, 31: 1110- 1116.

[9] Sharafuddin MJA , Gu XP, Ttus JL , et al. Transvenous closure of secumdum atrial septal defects: preliminary results with a new self-expanding nitinol prothesis in a swine model[J]. Circulation, 1997, 95: 2162- 2168.

备注/Memo

备注/Memo:
收稿日期：2001-03-09.
更新日期/Last Update: 2001-11-01