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国产双盘状封堵器经导管治疗膜部室间隔缺损疗效的初步评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第6期
页码:
518-520
栏目:
先心病介入治疗
出版日期:
2002-11-01

文章信息/Info

Title:
Transcatheter closure of membranous ventricular septal defects using the domestic-made two-plates form occluder:Initial clinical experience
作者:
张玉顺; 代政学; 贾国良; 刘建平; 王小燕
第四军医大学西京医院心血管内科,陕西西安710032
Author(s):
ZHANG Yu-shun; DAI Zheng-xue; JIA Guo-liang; LIU Jian-ping; WANG Xiao-yan
Cardiology Department of Xijing Hospital, Fourth Military Medical University, Xi' an,Shaanxi 710032,China
关键词:
室间隔缺损; 介入治疗
Keywords:
membranous ventricular septal defects ;  interventional therapy
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的 应用国产双盘状封堵器经导管治疗膜部室间隔缺损并对其疗效进行初步评价。方法 全组20例,年龄8±6(2~17)岁。室间隔缺损直径为7.2±2.3(2.0~14.0)mm。经7F或8F传送鞘置入双盘状封堵器,封堵后即刻行左心室造影,术后1 d及1月行超声心动图检查观察有无残余分流及再通。结果 全组技术成功率100%,术后左心室造影显示,6例存在微量~少量残余分流,14例封堵完全无残余分流。术后24 h、术后1月超声心动图未见残余分流及再通。结论 应用双盘状封堵器治疗膜部室间隔缺损是一种安全有效的介入方法,成功率高,近期疗效可靠,中远期疗效尚需进一步观察。
Abstract:
AIM To evaluate the treatment efficiency of transcatheter closure of membranous ventricular septal defects(MVSDs) using the domestic-made occluder device.METHODS Twenty patients with MVSDs underwent attempted transcatheter closure of a VSD using the Amplatzer occluder device at a age of 8±6 years (range 2.0 to 17.0) . The VSD diameter at its left ventricular side was 7.2±2.3 mm (rang 4.0 to 14.0). A 7F or 8F long sheath was used for delivery of the device. The left ventricular graphies(LVG) were performed to evaluate the results immediately after the procedure. Echocardiographies were performed 1 day, 1 month after the closure to find whether there was residual shunt and recanalization.RESULTS The technical success rate of the group was 100%. LVG showed that 14 patients had complete closure, 6 had a trace to small shunt immediately after the procedures. Within 24 h, color doppler revealed complete closure in all patients. No residual shunt and VSD recanlization after the complete closure were found in 1 month following up.CONCLUSION Transcatheter occlusion of MVSDs is safe and effective. It had a high successful rate of technique and satisfied immediate and short term results.Further clinical trials are underway to assess the long-term safety and results.

参考文献/References

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[2] Sideris EB, Walsh KP, Haddad JL,et al. Occlusion of congenital ventricular septal defects by the buttoned device. "Buttoned device" Clinical Trials International Register[J].Heart, 1997,77(3):276-279.

[3] Chaudhari M, Chessa M, Stumper O,et al. Transcatheter coil closure of muscular ventricular septal defects[J].J Interv Cardiol, 2001,14(2):165-168.

[4] Janorkar S, Goh T, Wilkinson J. Transcatheter closure of ventricular septal defects using the Rashkind device: initial experience[J].Catheter Cardiovasc Interv, 1999,46(1):43-48.

[5] Kalra GS, Verma PK, Dhall A,et al. Transcatheter device closure of ventricular septal defects: immediate results and inter-mediate-term follow-up[J].Am Heart J, 1999 ,138(2 Pt 1):339-344.

[6] Look JE,Block PC,McKay RG,et al. Transcatheter closure of ventricular septal defects[J].Circulation, 1998,78:361-368.

[7] Mullasari AS, Umesan CV, Krishnan U,et al. Transcatheter closure of post-myocardial infarction ventricular septal defect with Amplatzer septal occluder[J].Catheter Cardiovasc Interv,2001,54(4):484-487.

[8] Hijazi ZM, Hakim F, Al-Fadley F,et al. Transcatheter closure of single muscular ventricular septal defects using the Amplatzer muscular VSD occluder: initial results and technical considerations[J].Catheter Cardiovasc Interv, 2000,49(2):167- 172.

[9] Thanopoulos BD, Tsaousis GS, Konstadopoulou GN,et al.Transcatheter closure of muscular ventricular septal defects with the Amplatzer ventricular septal defect occluder: initial clinical applications in children[J].J Am Coll Cardiol, 1999, 33(5):1395-1399.

备注/Memo

备注/Memo:
收稿日期：2002-10-08.
更新日期/Last Update: 2002-11-01