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Title:: Comparison between transcatheter and surgical closure of secundum atrial septal defect in children

作者:: 谢育梅; 张智伟; 曾国洪; 庄建; 陈欣欣; 钱明阳; 石继军; 李俊杰; 广东省人民医院心血管病研究所，广东广州 510080

Author(s):: XIE Yumei; ZHANG Zhiwei; ZENG Guohong; ZHUANG Jian; CHEN Xinxin; QIAN Mingyang; SHI Jijun; LI Junjie; Institute of Heart Diseases, Guangdong Provincial Hospital, Guangzhou 510080, Guangdong, China

关键词:: 房间隔缺损; 介入治疗; 心脏外科手术

Keywords:: heart septal defect; atrial; interventional therapy; cardiac surgical procedure

分类号:: R654.2;R542.2

DOI:: -

文献标识码:: A

摘要:: 目的探讨国产房间隔缺损封堵器经导管封堵继发孔房间隔缺损的安全性、有效性和临床可行性，并与同期外科手术治疗的病例作相关对照。方法 2003年1月～2005年12月，78例自愿选择应用国产封堵器封堵房间隔缺损的患儿与90例同期进行外科手术治疗的患儿进行治疗前后的对比，对相关检测指标、手术成功率、并发症、手术时间和住院时间、治疗费用作对照分析，治疗后定期随诊超声心动图和心电图。结果两组患儿在年龄、体质量、术前肺动脉压力、右心室舒张末内径、封堵成功率和手术成功率、手术死亡率差异无统计学意义。介入治疗组随访3～32个月，外科组随访6～24个月均无严重并发症，病死率均为0％。结论国产封堵器封堵继发孔房间隔缺损安全、成功率高，短中期疗效确切，在适应征允许范围内，可替代外科手术治疗。

Abstract:: AIM To compare the safety, efficacy and clinical application of Chinamade closure device for secundum atrial septal defect (ASD) with surgical closure. METHODS Consecutive local children with secundum ASDs, who were admitted between 1 January 2003 and 31 December 2005, were included in the study. The patients were assigned to either the device or surgical closure group according to the patients′ option. Baseline physical examinations and echocardiogram were performed preprocedure and followup. RESULTS The mortality was 0% for both groups. Seventyeight patients underwent device closure and 90 patients underwent surgical repair. The median age and weight were 7.12 years and 23.13 kg for the device group, and 6.38 years and 18.89 kg for the surgical group. The size of the primary ASD was (15.26±5.69)mm for the device group and (17.14±4.93)mm for the surgical group (P=0.102). The procedural success rate was 100% for both groups. The efficacy success rates was 97.4% for the device group and 98.9% for the surgical group. The complication rate was 3.8% for the device group and 18.9% for the surgical group (P<0.001). The mean length of hospital stay was (5.2±0.7) days for the device group and (9.1±1.8)days for the surgical group (P<0.05). CONCLUSION Transcatheter closure of secundum ASD with Chinamade device is a safe and effective alternative to surgical repair.

参考文献/References

［1］ Masura J, Gavora P, Formanek A, et al. Transcatheter closure of secundum atrial septal defects using the new selfcentering Amplatzer septal occluder: initial human experience［J］. Cathet Cardiovasc Diagn, 1997, 42(4):388-393.

［2］ Thanopoulos BD, Laskari CV, Tsaousis GS, et al. Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results［J］. J Am Coll Cardiol, 1998, 31(5):1110-1116.

［3］ Hijazi ZM, Cao Q, Patel HT, et al. Transesophageal echocardiographic results of catheter closure of atrial septal septal defect in children and adults using the Amplatzer device［J］. Am J Cardiol, 2000, 85(11):1387-1390.

［4］ Zahn EM, Wilson N, Cutright W, et al. Development and testing of the Helex septal occluder, a new expanded polytetrafluoroethylene atrial septal defect occlusion system［J］. Circulation, 2001, 104(6):711-716.

［5］ Du ZD, Hijazi ZM, Kleinman CS, et al. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial［J］. J Am Call Cardial, 2002, 39(11):1836-1844.

［6］ Hughes ML, Maskell G, Goh TH, et al. Prospective comparison of costs and short term health outcomes of surgical versus device closure of atrial septal defect in children［J］. Heart , 2002, 88(1):67-70.

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国产双盘封堵器封堵儿童继发孔房间隔缺损与外科手术的对照研究 (PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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