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Amplatzer封堵器经导管治疗多孔房间隔缺损(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第4期
页码:
331-333
栏目:
先心病介入治疗
出版日期:
2002-07-01

文章信息/Info

Title:
Transcatheter closure of multiple secundum atrial septal defects using Amplatzer septal occluder
作者:
李 寰; 张玉顺; 贾国良; 张 军; 刘建平; 何 争; 代正学; 李 媛; 王晓燕
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; JIA Guo-liang; ZHANG Jun; LIU Jian-ping; HE Zheng; DAI Zhen-xue; LI Yuan; WANG Xiao-yan
Department of Cardiovasology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032,China
关键词:
房间隔缺损; Amplatzer封堵器
Keywords:
atrial septal defect;  amplatzer occluder
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 探讨Amplatzer封堵器经导管治疗多孔房间隔缺损的临床应用价值。方法 全组患者6(男2,女4)例,年龄4~50岁,经TTE或TEE检查诊断为多孔房间隔缺损。均在X线和TTE或TEE监测下经导管行Amplatzer 封堵器治疗。术后重复TTE或TEE、ECG及X线平片检查以评价疗效。结果 全组6例患者Amplatzer封堵器置入均获成功,术中无重要并发症发生。其中置入1个封堵器的患者5例,置入2个封堵器的患者1例。术后即刻TTE或TEE检查5例无残余分流,1例小缺损孔有少量残余分流,随访1年中少量残余分流仍存在。1例肺动脉压中度增高患者,术后30 min测量肺动脉压下降>20 mm Hg。随访期间所有患者封堵器位置形态良好,未发现封堵器的变形,移位以及金属结构断裂等改变;右房,右室有不同程度的缩小,X线平片显示肺血有不同程度减少;术后ECG检查均未见心律失常发生。结论 Amplatzer封堵器经导管治疗多孔房间隔缺损是安全有效的。对于相隔距离较近的多孔房间隔缺损,可采用单个封堵器封堵;而相隔距离较远的缺损,可采用同时置入两个封堵器。
Abstract:
AIM To investigate the effectiveness and safety of transcatheter closure of multiple secundum atrial septal defect (ASD) using Amplatzer septal occluder.METHODS 6 Patients (2 mals, and 4 females) diagnosed of multiple ASDs by TTE or TEE were investigated. The age rangs from 4 to 50 years. All the patients received transcatheter closure of ASD guided by X ray fluoroscopy and echocardiography by using Amplatzer septal occluder. TTE or TEE, ECG, X-ray examinations were repeated after the procedures as follow-ups to evaluate the safety and efficiency.RESULTS The placement of the occluders were successful in all the 6 patients. There was no serious complication during the procedure. 1 occluder was implanted in each of 5 patients, and 2 occluders were implanted in the other 1 patient. 5 of the patients showed no residual shunt immediately after the procedure examined by TTE or TEE, While one patient implanted with one occluder showed trial or small residual shunt of small defect. Trial or small residual shunt of small defect also existed in one year' s follow-up. One patient with pulmonary hypertension, pulmonary pressure decreased above 20 mm Hg 30 min after the procedure. The shape and the position of all the occluders were good during the follow-up. No displacement and malformation of the occluders were found. Heart size and pulmonary vascularity were improved in all the patients during the follow-up. No arrhythmia occurred during the follow-up.CONCLUSION Transcatheter closure of multiple secundum ASD using Amplatzer septal occluder is safe and effective. One occluder can be used in the multiple ASD with short distance between the defects, and 2 occluders can be used with long distance.

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, 1997,42:388-393.

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

[3] 戴汝平,刘延玲,张戈军,等.应用Amplatzer封堵器介入治疗房间隔缺损疗效评价(附60例报告)[J].中华心血管病杂志,2000,28:87-92.

[4] 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.

[5] 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：2001-11-08.
更新日期/Last Update: 2002-07-01