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应用Amplatzer封堵器介入治疗继发孔房间隔缺损远期疗效观察(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第6期
页码:
716-719
栏目:
临床研究
出版日期:
2007-12-20

文章信息/Info

Title:
Long term followup of transactheter closure of atrial septal defect with Amplatzer occluder
作者:
马翔; 马依彤; 杨毅宁; 汤宝鹏; 黄定; 刘晓; 穆玉明; 韩伟
新疆医科大学第一附属医院心血管病专科医院，新疆 乌鲁木齐 830054
Author(s):
MA Xiang;  MA Yitong;  YANG Yining;  TANG Baopeng;  HUANG Ding;  LIU Xiao; MU Yuming;  HAN Wei
First Teaching Hospital, Xinjiang Medical University, Urumqi 830054, Xinjiang, China
关键词:
房间隔缺损; 心脏导管插入术; Amplatzer封堵器; 远期疗效
Keywords:
atrial septal defect;  heart catheterization;  Amplatzer occluder;  long term effect
分类号:
R541.1;R654.2
DOI:
-
文献标识码:
A
摘要:
目的 观察应用Amplatzer封堵器治疗继发孔房间隔缺损的术后远期疗效及安全性。方法 应用Amplatzer封堵器治疗129例房间隔缺损（ASD）患者，于术后随访观察并发症的发生及心功能的改变，同时记录心脏超声、心电图及胸片结果。结果 所有患者术后随访19～62（40±12）月。随访中所有Amplatzer封堵器位置准确、稳定，无装置变形及折断，无脱落、溶血等严重并发症。ASD患者术后左室收缩功能较术前显著改善［(1±10）％ vs（73±11）％,P<0.05］,直径大于20 mm及缺损残余边缘≤4 mm的ASD患者，术后心功能改善明显。心电图随访未见房颤、房扑及室性心律失常，92例原有右束支传导阻滞患者中，17例消失于术后6个月内，75例成为永久性。胸片随访示全部患者肺血减少、心胸比例不同程度缩小。结论 Amplatzer封堵器治疗ASD改善了心功能，并发症少，远期疗效肯定。
Abstract:
AIM To identify long term outcomes of the transactheter closure of the atrial septal defect with Amplatzer occluder. METHODS One hundred twentynine patients with the atrial septal defect were treated with Amplatzer occluder device through percutaneous procedure. The patients were assessed with echocardiography, twelvelead electrocardiography and chest Xray before and after transcatheter closure and during the long term followup. RESULTS All Amplatzer occluder were in good place, nicely and stably. No severe complication was found during the followup. The left ventricular systolic function increased significantly in all patients［（61±10）％ vs（73±11）％（P<0.05）］. Electrocardiographic analysis showed that there was no atrial fibrillation, atrial flutter or ventricular arrhythmia. Among the 92 cases with RBBB, RBBB disappeared in 17 cases six months after operation and 75 cases still had it. CONCLUSION Transactheter closure of atrial septal defect with Amplatzer occluder increases ventricular systolic function and produces good clinical longterm outcomes.

参考文献/References

［1］ King TD, Thompson SL, Steiner C. Secondum atrial septal defects: nonoperative closure during cardiac catheterization［J］. JAMA, 1976, 235(23): 2506-2509.

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

［3］ Veldtman.GR, Razark V, Siu S, et al. Right ventricular form and function after percutaneous atrial septal defect device closure［J］. J Am Coll Cardiol, 2001, 37(8): 2108-2113.

［4］ Dhillon R, Josen M, Henein N. Transcatheter closure of atrial septal defect preserves right ventricular function［J］. Heart, 2002, 87(5): 461-465.

［5］ Berger F, Ewert P, Bjornstad PG, et al. Transcatheter closure as standard treatment for most interatrial defect: experience in 200 patients treated with Amplatzer Septal Occluder［J］. Cardiol Young, 1999, 9(5): 468-473.

［6］ Cowley CG, Lloyd TR, Bove EL, et al. Comparison of result of closure of secondum atrial septal defect by surgery verse Amplatzer septal occluder ［J］. Am J Cardiol, 2001, 88(5): 589-591.

［7］ Popio KA, Gorlin R, Teichholz LE, et al. Abnormalities of left ventricular function and geometry in adults with an atrial septal defect［J］. Am J Cardiol, 1975, 36(3): 302-308.

［8］ Du ZD, Koenig P, Cao QL, et al. Comparision of transcatheter closure of secundum atrial septal defect using the amplatzer septal occluder associated with deficient versus sufficient rims［J］. Am J Cardiol, 2002, 90(8): 865-869.

［9］ Berger F, Ewert P, Abdulkhalip H, et al. Percutaneous closure of large atrial septal defects with the Amplatzer septal Occluder: technical overkill or recommendable alternative treatment?［J］. Interv Cardiol, 2001, 14(1): 63-67.

［10］ Losay J,Petit J,Lambert V, et al. Percutaneous closure with Amplatzer device is a safe and efficient alternative to surgery in adults with large atrial septal defects［J］. Heart, 2001, 142(3): 544-548.

备注/Memo

备注/Memo:
收稿日期：2006-08-09.作者简介：通讯作者：马依彤，主任医师，教授，主要从事心血管病介入诊疗 Email:myt-xj@163.com 作者简介：马翔，主任医师，博士 Email:maxiangsfy@yahoo.com
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