我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

房间隔缺损封堵治疗中Amplatzer封堵器的非常规方法选择(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第2期
页码:
139-141
栏目:
临床研究
出版日期:
2003-03-01

文章信息/Info

Title:
Amplatzer septal occluder device selection by unconventional methods in transcatheter interventions
作者:
李敬邦1; 张玉顺2; 李寰2; 张军3; 代政学2
第四军医大学西京医院:1.放射科,2.心血管内科,3.超声科,陕西 西安 710032
Author(s):
LI Jing-bang1; ZHANG Yu-shun2; LI Huan2; ZHANG Jun3; DAI Zheng-xue2
1.Department of Radiology,Xi jing Hospital,Fourth Military Medical University,Xi'an,Shaanxi 710032,China
关键词:
房间隔缺损; 非常规方法; 封堵器
Keywords:
Atrial septal defect; Transcatheter closure; occluder
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的:研究非常规方法选择Amplatzer房间隔缺损封堵器的可行性。方法:患者158例,年龄1～65(27士19) 岁。其中常规组41例,非常规组117例。非常规组按照选择封堵器的最终依据不同,分为3组。A组:33例,根据食 道超声心动图(TEE)测量的ASD最大径直接选择封堵器;B组:46例在经胸超声心动图(TTE)监测指导下球囊充 盈测量ASD伸展径(BSD),根据BSD选择封堵器;C组:38例,根据TTE测量的ASD最大径直接选择封堵器。结 果:各组患者ASD的边缘、大小和选择封堵器的大小之间均无显著性差异(P>0.05)。各组技术成功率均为 100%。非常规各组完全闭合率与常规组无显著性差异(P>0.05),但手术操作时和(或)透视时间均明显短于常规 组(P<0.01)。结论:非常规法选择Amplatzer封堵器对大部分ASD介入治疗是安全可行的。对于房缺周缘较长、 较硬者,及边缘为硬缘和极软缘组成而剔除极软缘者,TEE或TTE可直接指导Amplatzer封堵器型号的选择。对 于房缺缘较软者,应结合球囊测量房缺伸展径选择封堵器。
Abstract:
AIM:To investigate the feasibility of the selection of Amplatzer septal occluder(ASO) device by means of unconventional methods. METHODS: There were 158 patients.The mean age was 26.8±18.6years (ranging from 1 to 65years).The patients were divided into 2 groups, the conventional group (n=41) and the unconventional group (n=117) according to the way of ASO selection. The 117 patients in the unconventional group were divided into 3 groups.In group A (n=33), ASO device was selected based on the transeophageal echocardiograph (TEE).In group B (n=46) as device was selected according to the balloon stretched diameter(BSD) measured by transthoracic echocardiography (TTE);and in group C(n=38),the ASO device was chosen according to the TTE measured diameters. RESULTS: There was nosignificant difference between the four groups in the largest ASD diameter measured by TTE or TEE, the size of ASD edge and the size of implanted ASO devices P>0.05). There were all successful implantations in the four groups. The rates of complete closure of ASD were not significantly differen tbetween the four groups soon after the implantation, 1 day after the implantation, and in a short time follow-upduration(P>0.05).Both procedural time and fluoroscopy time in unconventional group were significantly shorter than those in the conventionalgroup (P < 0.01).CONCLUSION:Transcatheter closure of secundum ASD occlusion with ASO by unconventional methods was safe and efficient in some ASD patients.TEE or TTE can be used for guidance of ASO selection of ASD without the measurement of BSD of ASD in the following conditions:①ASD with solidedge;②ASD with very soft and floppy edge attached to solid basement,with only the solid basement measured with TEE.However,BSD should be measured in ASD with soft and floppy edge.

参考文献/References

[1]Fisher G,Kramer HH,Stieh J,et al.Transcatheter closure ofsecundum atrial septal defects with new self-centering Amplatzer Septal Occluder [J].EurHeart J,1999,20(7):541-549.

[2]BergerF,EwertP,Abdul khaliq H,et al. Percutaneous closure of large atrial septal defect swith the Amplatzer septal occluder:Technical overkill or recommendable treatment[J]?. J Interven Cardiol, 2001,14(1):63-67.

[3]Rao PS,Langhough R.Relationship of echocardiographic,shunt flow and angiographic size of the stretched diameter of atrial septal defect [J].Am Heart J,1991,122:505-508.

[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,2000,12:379-381.

[5] Hijazi ZM, Cao Q, Patel HT, et al.Transesophageal echocardiogrophic results of catheter closure of atrial septal defect in children and adults using the Amplatzer device [J].AmJCardiol,2000,85:1387-1390.

[6]徐立,戴汝平,刘延玲,等.Amplatzer法房间隔缺损封堵术--经食道超声心动图测量选择封堵器的可行性[J].中华心血管病杂志,2001,29(5):297-299.

[7]Minich LL,Snider AR.Echocardiographic guidance during placement of the buttoned - disk devence for atrial septal defect closure [J]. Echocardiography,1993,10:567-572

. [8] Ishii M,Kato H,Inone O,et al.Biplane transesophageal echo-Doppler studies of atrial septal defects: quantitative evaluation and monitoring for transcatheter closure [J].Am HeartJ,1993,125:1363-1368.

[9] GodartF, Rey C, FrancartC, et al. Two-dimensional echocardiographic and color Doppler measurements of atrial septal defect,and comparison with the ballon-stretched diameter [J]. Am J Cardiol,1993,72:1095-1097

备注/Memo

备注/Memo:
收稿日期：2002-6-3.
更新日期/Last Update: 2003-03-01