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Amplatzer 房间隔封堵器治疗200例的并发症(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第6期
页码:
549-551
栏目:
介入治疗
出版日期:
2003-11-01

文章信息/Info

Title:
Complications of consecutive 200 cases with Amplatzer atrial defect occluder
作者:
李寰; 张玉顺; 吴栋梁; 贾国良; 代政学; 何争; 王小燕
第四军医大学西京医院心血管内科, 陕西 西安 710032
Author(s):
LI Huan;  ZHANG Yu-shun;  WU Dong-liang;  JIA Guo-liang;  DAI Zheng-xue;  HE Zheng;  WANG Xiao-yan
Department of Cardiology, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi 710032, China
关键词:
Amplatzer 封堵器; 房间隔缺损; 并发症
Keywords:
Amplatzer atrial septal defect occluder;  atrial septal defect;  complication
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的:总结我院连续200例房间隔缺损采用Amplatzer封堵器治疗的并发症。方法: 接受治疗的患者200(男68, 女132)例, 年龄26±16(1.0～67)岁, 均经症状、体征、X 线、ECG、B 超等确诊为房间隔缺损, 并发肺动脉瓣狭窄5例, 二尖瓣狭窄2例, 动脉导管未闭2例, 多孔房间隔缺损10例。所有患者在我院行Amplatzer房间隔缺损封堵治疗, 同时观察术中、术后出现的并发症。结果: 房间隔缺损大小为20±8(2.5～37)mm, 植入的封堵器大小为26±9(5～40)mm, 共植入Amplatzer 房间隔封堵器203个, 技术成功率99.5%, 同时植入2个封堵器的患者共4例。严重并发症发生率为2%(4例), 1 例术后心包填塞急诊转到心脏外科手术; 1例术后2d 出现不明原因的脑出血; 1例术中导管断裂, 急诊转心脏外科手术取出断裂导管并行修补术; 1例术后3月、6月出现封堵器内少至中量分流。其他并发症有术中出现ST段弓背向上抬高8例, 暂时性?度?型及?度?型房室传导阻滞各2例, 术后发生房颤4例。结论: Amplatzer 封堵器治疗房间隔缺损严重并发症发生率低, 作者认为是一种安全、可靠的方法。
Abstract:
AIM: To review the complications of consecutive 200 cases of atrial septal defects having received treatment of Amplatzer atrial defect occluder in our hospital. METHODS: Consecutive 200 patients (68 male, 132 female) aged 26±16 (ranging from 1.0 to 67 years old) were diagnosed as atrial septal defects by symptoms, physical signs, X-rays, ECG and ultrasounds. Among them 5 combined with pulmonary arterial valve stenosis, 2 with mitral valve stenosis, 2 with patent ductus arteriosus and 10 having multiple pores. All patients were treated with Amplatzer atrial septal defect occluders in our hospital and the complications were reviewed. RESULTS: The size of atrial septal defect was 20±8 (from 2.5 to 37)mm. The implanting occluder was 26±9(from 5 to 40)mm. The total of 203 Amplatzer occluders had been implanted. The technique success rate was 99.5%. Four patients had 2 occluders implanted at the same time. The incidence of serious complication was 2%. Pericardial tamponade after the procedure occurred in one patient, who was in no time undergo cardiac surgery. One patient got uncertain cerebral hemorrhage after 2 days of occluder implant. Catheter broken in one patient during the procedure and the patient received emergency cardiac surgery. One case was found small to medium shunt through the occluder after 3 and 6 months of the occlusion. Other complications including ST elegated during the procedurein in 8 cases, temporary ? °? atrial ventricular block in in 2 cases and ? °? atrial ventricular block in 2 cases. Atrial fibrillation occurred in 4 patients after occlusion. CONCLUSION: The incidence of serious complication of Amplatzer atrial septal defect occluder is very low, which suggests that transcatheter occlusion of atrial septal defect with Amplatzer is a safe and effective method.

参考文献/References

[1] Thanopoulos BD, Laskari CV, Tsaousis GS, et al. Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results [J] . JACC, 1998, 31(5):1110-1115.

[2] 张玉顺, 贾国良, 何争, 等. 应用Amplatzer 封堵器治疗房间隔缺损 [J] . 心脏杂志, 2000, 12(5):379-381.

[3] 温朝阳, 李越, 王廉一, 等. 超声引导Amplatzer封堵器关闭房间隔缺损的初步体会 [J] . 中华超声影像学杂志, 1999, 8(5):283- 285.

[4] 张玉顺, 张军, 李寰, 等. Amplatzer 封堵法改良? ——经胸超声心动图测量值指导选择封堵器的可行性 [J] . 第四军医大学学报, 2002, 23(2):180-182.

[5] 张军, 李军, 张玉顺, 等. 超声心动图指导Amplatzer封堵器在房间隔缺损封堵中的价值 [J] . 中国超声医学杂志, 2001, 17(6):425-428.

备注/Memo

备注/Memo:
收稿日期：2002-09-16.
更新日期/Last Update: 2003-11-01