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房间隔瘤并发继发孔房间隔缺损的介入治疗评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第3期
页码:
260-262
栏目:
介入治疗
出版日期:
2005-05-05

文章信息/Info

Title:
Evaluation of transcatheter closure of atrial septal aneurysm associated with secoundum atrial septal defect
作者:
张玉顺1; 李寰1; 代政学1; 李军2; 张军2
第四军医大学西京医院：1.心脏内科，2.超声诊断科， 陕西 西安 710032
Author(s):
ZHANG Yushun1;  LI Huan1;  DAI Zhengxue1;  LI Jun2;  ZHANG Jun2
1.Department of Cardiology, 2.Department of ultrasonic diagnosis, Xijing Hospital, Fourth Military Medical University, Xi'an,Shaanxi 710032,China
关键词:
房间隔瘤;  房间隔缺损;  介入治疗; 封堵器
Keywords:
atrial septal aneurysm;  atrial septal defect;  interventional therapy;  occluder
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 评价房间隔瘤（ASA）并发继发孔型房间隔缺损(ASD)介入治疗的临床效果。方法 全组21(男8,女13)例，年龄9~56(24士14)岁。经临床、心电图、X线及经胸超声心动图(TTE)检查诊断为ASA并发继发孔型ASD。TTE检查ASA均膨入右心房，测量ASD最大直径12~28（19±7）mm。其中单孔ASD 13例，多孔ASD 8例，孔间距离1~7 mm者7例，12 mm者1例。结果 21例均一次封堵成功，技术成功率100%。所用封堵器的直径为16~40（25±8）mm。8例多孔ASD，有7例置入1个封堵器直接封堵多个缺损孔，1例（两个缺损孔之间距离为12 mm）分别用18 mm和12 mm两个封堵器封堵。术后即刻 TTE检查显示16例获完全闭合，5例有少或微量残余分流，完全堵闭率76%(16／21)。术后3 d复查TTE 2例(10％)有微量残余分流。1~6个月复查19例（90%）心脏大小恢复正常，2例（10%）并发心房纤颤患者心脏不同程度的缩小，1例有微量残余分流。1年后随访12例，无封堵器移位及其他并发症。结论 介入治疗房间隔瘤（ASA）并发继发孔型ASD具有操作简便、安全、技术成功率高及封堵效果好等优点。
Abstract:
AIM To evaluate the effects of transactheter closure of atrial septal aneurysm (ASA) associated with secoundum atrial septal defect (ASD). METHODS Total 21 (8 male, 13 female) patients, aged from 9 to 56 (average, 24±14) were investigated. All patients were diagnosed of ASA associated with ASD by physical examination, ECG, Xray and TTE. ASAs were all convexed into right atrial. The largest diameter of ASD was from 12 to 28 (average, 19±7) mm. 13 cases with single hole ASD, and 8 cases with multiple holes ASD. 7 cases with the distance between each ASD holes were from 1 to 7 mm, and 1 case with the distance between each ASD holes was 12 mm. RESULTS Total 21 cases were all successfully occluded just for once, the technique success rate was 100%. The size of implanting occluders were from 16 to 40 (average, 25±8) mm. In 8 cases with multiple ASD, 7 cases implanted only one occluder to close multiple ASD holes, another 1 case, in which the distance between each ASD holes were 12 mm, were closed by implanting two occluders (18 mm,12 mm occluder,respectively). Immediately after occlusion, examined by TTE, ASD was completely closed in 16 cases, and micro to small residual shunt was found in another 5 cases. The complete closure rate was 76% (16/21). 3 d after occlusion, examined by TTE, residual shunt was found in 2 cases (10%). During 1~6 months followup, heart size resumed to normal in 19 cases (90%); and another 2 cases(10%) with atrial fibrillation, heart sizes were decreased; micro residual shunt was found in 1 case. 12 cases during 1year followup, none was found occluder shift and other complications. CONCLUSION Transcatheter closure of ASA associated with ASD is safe, easy to operate, with high technique success rate and good result.

参考文献/References

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［2］Hanley PC, Tajik AT, Hynes JK, et al. Diagnosis classification of atrial septal aneurysm by two dimensional echocardiography: report of 80 cases［J］. J Am Coll Cardiol, 1985,6(6):1370-1373.

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［4］张玉顺，代政学，刘建平，等. 经胸超声心动图监视下应用Amplatzer封堵器治疗房间隔缺损［J］. 心脏杂.2001,13(5):393-395.

［5］张玉顺 ,张军,代政学,等. 经胸超声心动图和X线透视引导下行房间隔封堵术［J］. 中华放射学杂志,2003,37(4):356-359.

［6］李寰,张玉顺,贾国良,等.Amplatzer封堵器经导管治疗多孔房间隔缺损［J］. 心脏杂志,2002,14(4).331-333.

［7］Pedra CAC, FontesPedra SRF, Esteves CA, et al. Multiple atrial septal defects and patent ductus arteriosus: successful outcome using two Amplatzer septal occluders and Gianturco coils［J］. Cathet Cardiovasc Diagn, 1998,45:257-259.

备注/Memo

备注/Memo:
收稿日期：2004-12-30.
更新日期/Last Update: 2010-01-05