40岁以上继发孔型房间隔缺损介入治疗的评价(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2003年第3期
- 页码:
- 249-251
- 栏目:
- 介入治疗
- 出版日期:
- 2003-05-01
文章信息/Info
- Title:
- Transcatheter closure of secundum atrial septal defects in patients above 40 years old
- Author(s):
- ZHANGYu-shun1; LIHuan1; ZHANGJun2; DAIZheng-xue1; WUDong-liang 1; WANGXiao-yan 1
- 1.Department of Cardiology,2.Department of Ultrasound,Xijing Hospital,Fourth Military Medical University,Xi'an,Shaanxi710032,China
- Keywords:
- atrial septal defects; transcatheter closure
- 分类号:
- R541
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的:评价40岁以上继发孔型房间隔缺损(ASD)介入治疗的效果。方法:全组45例,年龄40～65(49土7)岁。术前超声心动图检查ASD最大直径8～38(27土7)mm。并发高血压13例,糖尿病2例,三尖瓣关闭不全29例,二尖瓣关闭不全8例,心房纤颤4例,频发房性早搏9例。所有病例均经导管置入AmplatzerASD封堵器。1例大小紧邻的两个ASD,采用一个封堵器关闭两个缺损。1例两个ASD相距较远,用两个封堵器分别关闭。术后48h,1～3月分别行经胸超声心动图(TTE)、心电图及X线检查。结果:44例选择的封堵器直径为10～40(31土7)mm。1例双孔ASD(分别8mm和16mm),分别采用12mm和20mm两个封堵器。封堵器置入均获得成功,技术成功率为100%,术中未发生任何重要并发症,无急诊手术病例。术后即刻,TTE显示3例(7%)存在微量至少量残余分流;术后48hTTE显示2例(4.4%)存在微量至少量残余分流;术后3月无1例残余分流。术后右心房、室缩小,心功能明显改善。结论:Amplatzer封堵器适合于40岁以上继发孔型ASD的介入治疗,具有操作简便、安全、技术成功率高及封堵效果好等优点。
- Abstract:
- AIM:To evaluate the therapeutic efficacy of transcather closure of secundum atrial septal defect (ASD) in elderly patients using Amplatzer occluder device.METHODS:There were 46 patients.The age was 49±7 years(ranging from 40to65years).The diameter of ASD was 27±7mm(ranging from8to38mm)shown by echocar diography before the interventions.Two cases had double ASD.There were 13 patients with hypertension,2 with diabetes,29 patients with tricuspid regurgitation,8 with mitral valve regurgitation,4 with atrial fibrillation ,and 9 with atrialpremature beats.Each case was occluded using Amplatzer occluder device through the percutaneous procedure .Echocardiography was performed immediately,and echocardiography,ECG and X-ray examination were performed 48 h and 1～3 months after the procedure to evaluate the efficacy.RESULTS:The diameter of the occluder selected was 31±7mm (ranging from 10～40mm ). In one case with double ASD (8mm and 16mm),2 occluders,12mm and20mm respectively, were used. The success rate of the placement of Amplatzer occluder was 100%.No complications occurred during the procedure,and no one needed emergency surgery.Trivial to small residual shunts were found in 3 cases(7%) immediately after the procedure,and in 2 cases (4%)48 h after the procedure.No residual shunts was found in 3 months follow-up.Echocardiography and X-ray examination showed that pulmonaryvascularity and heartsize were improved. CONCLUSION:Transcatheter closure of secundum ASD using Amplatzer occluder device was an effective nonsurgical method for patients above 40 years old.It had a high successful rate of technique and satisfactory immediate and short term results
参考文献/References
[1]张玉顺,贾国良,刘建平,等.应用Amplatzer封堵器治疗房间隔缺损疗效评价[J].心脏杂志,2001,13(6):476-478
.[2]张玉顺,李寰,张军,等.经胸超声心动图指导下Amplatzer封堵成人房间隔缺损[J].第四军医大学学报,2002,23(1):28-30.
[3]石应康.胸心血管外科学[M].北京:人民卫生出版社,2001.952-956.
[4] Landzberg MJ. Closure of atrial septal defects in adult patients: Justification of the " Tipping point"[J].J Interven Cardiol,2001,14:267-270.
[5] St. JohnSutton MG,Tajik AJ,McGoon DC.Atrial septal defect in patients ages 60 years or older: operative results and long-term postoperative follow-up [J].Circulation,1981,64:402-409.
[6] Murphy JG, Gersh BJ, Mcgoon MD, et al.Long-term outcome after surgical repair of isolated atrial septal defect.Follow-upat 27 to 32 years [J]. NEngl J Med, 1990,323(24):1645-1650.
[7] Gatzoulis M, Freeman M, Siu S,et al.Atrial arrhythmia after surgical closure of atrial septal defects in adults [J].N Engl J Med,1999,340:839-846.
[8] Steele PM,Fuster V,Cohen M,et al.Isolated atrial septal defect with pulmonary vascular obstructive disease long-term follow-up and prediction of outcome after surgical correction [J]. Circulation, 1987, 76(5):1037-1042.
[9]代政学,张玉顺,吴栋梁,等.房间隔缺损并发心房纤颤患者应用Amplatzer伞封堵房缺后心房纤颤的电复律治疗[J].心脏杂志,2001,13:391-395.
备注/Memo
- 备注/Memo:
- 收稿日期：2002-1-24.
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