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|本期目录/Table of Contents|

房间隔缺损并发畸形的介入治疗(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第2期
页码:
152-153,156
栏目:
临床研究
出版日期:
2002-03-01

文章信息/Info

Title:
Transcatheter closure of complex atrial septal defects
作者:
代政学1;  张玉顺1;  李　寰1;  贾国良1;  刘建平2;  张　军3;  王小燕1
第四军医大学西京医院: 1. 心血管内科, 2. 小儿科, 3. 超声科, 陕西 西安 710032
Author(s):
DAI Zheng-xue1;  ZHANG Yu-shun1;  LI Huan1;  JIA Guo-liang1;  LIU Jian-ping2;  ZHANG Jun3;  WANG Xiao-yan1
1.Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710032, China
关键词:
房间隔缺损;  介入治疗
Keywords:
atrial septal defects;  transcatheter closure
分类号:
R541.1;R654.2
DOI:
-
文献标识码:
A
摘要:
目的 评价同期应用介入治疗房间隔缺损(ASD)及其并发心脏其它畸形的可行性和治疗效果.方法 全组7例,年龄2～65(34±28)岁.经临床、心电图、X线及超声心动图诊断为ASD并发其他心脏畸形,其中3例为肺动脉瓣狭窄,2例为二尖瓣狭窄(Lutembacher综合征),2例为动脉导管未闭(PDA).应用Amplatzer封堵器经导管关闭ASD前,先纠正其它畸形(包括瓣膜成形术及PDA封堵术).术后3 d,1～6 月分别行经胸超声心动图(TTE)、心电图、X线检查评价治疗效果.结果 7例同期介入治疗均获得成功,术中未发生任何重要并发症.术后3 d,1～6月 TTE显示房间隔无残余分流.并发肺动脉瓣狭窄患者,术后即刻跨肺动脉瓣压差得到满意的下降;Lutembacher综合征患者,二尖瓣瓣口面积分别由术前1.0,1.2 cm2增加到术后1.9,2.0 cm2,左房平均压分别由29,26 mm Hg(1 mm Hg=0.133 kPa)降至8,7 mm Hg;并发PDA患者,应用Amplatzer封堵器PDA关闭术后10 min降主动脉侧位造影,无残余分流.术后6月 X线检查显示肺血减少,心脏房、室缩小.结论 同期介入治疗ASD并发某些心脏畸形是一种有效、安全、简便可行的方法.
Abstract:
AIM To evaluate the efficiency and feasibility by transcatheter therapy of complex atrial septal defect(ASD) . METHODS 7 patients with complex ASD were treated in or during with the same procedure by combined transcatheter techniques(balloon valvuloplasty and patent ductus arteriosus occlusing) before ASD occlusion using Amplatzer occluder device. Three patients had pulmonary stenosis, two had mitral stenosis(Lutembacher syndrome), two had patent ductus arteriosus(PDA). Transthoracic echocardiography(TTE), ECG and X-ray examination were done 3 days and 1～ 6months after the procedure to evaluate the efficiency. RESULTS The success rate of transcatheter therapy of complex atrial septal defect was 100%. No complications occurred during the procedure, No residual shunts were found 3 days after the procedure and in 1～ 6 month follow-up. Satisfactory reduction of pressure gradient across valve and complete obiteration of left to right atrial were achieved for ASD associated with pulmonary stenosis. Mitral valve area increased from 1. 0, 1. 2 to 1. 9, 2. 0 cm2, the mean left atrial pressure decreased from 29, 26mmHg to 8, 7mm Hg for two Lutembacher syndromes respectively. The lateral descending aortographies indicated complete immediate closure of PDA 10minutes after PDA occluder placement for two ASD patients with PDA. X-ray examination showed that pulmonary vascularity and heart size were improved. CONCLUSION Transcatheter therapy of complex ASD was an effective, feasible and safe nonsurgical method.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2001-11-12.
更新日期/Last Update: 2002-03-01