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国产封堵器介入治疗房间隔缺损后右心形态和功能的变化(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第3期
页码:
235-237
栏目:
介入治疗
出版日期:
2005-05-05

文章信息/Info

Title:
Morphological and functional changes of the right heart after transcatheter closure of atrial septal defects using the domesticmade occluder device
作者:
和旭梅1; 张玉顺1; 李寰1; 代政学1; 张军2; 李军2
第四军医大学西京医院：1.心脏内科，2.超声诊断科，陕西 西安710032
Author(s):
HE Xumei1;  ZHANG Yushun1;  LI Huan1;  DAI Zhengxue1;  ZHANG Jun2;  LI Jun2
1.Department of Cardiology, 2.Department of Echocardiography, 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 defect;  transcatheter closure
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 评价国产封堵器介入治疗房间隔缺损(ASD)后右心形态和功能的变化规律。方法 患者41(男15，女26)例，经胸超声(TTE)示ASD最大径5~34(19.4±7.4)mm，选用封堵器型号为8~44(25±9)mm.。术后即刻、2 d、3和6月行TTE追踪测量及随访。心尖四腔切面面积—长度法计算右心室容积及射血分数。结果 房缺封堵术后2 d及3月随访,右心房上下径、左右径,舒张末期右心室前后径、左右径均进行性减小,与术前比较有显著差异(Ｐ<0. 05，P<0.01)。术后2 d右心室的舒张末期容积较术前明显减小(Ｐ<0 05)，右室射血分数逐渐趋于正常。3月右心室的舒张末期容积、收缩末期容积和射血分数进一步改善。3~6月右心房、室大小基本恢复正常。结论 国产封堵器封堵ASD后右心形态和功能的变化规律与Amplatzer封堵器引起的相一致，即在消除异常分流的同时，有效改善右心室容量负荷状态和右心系统的几何构型。
Abstract:
AIM To evaluate the changes of the right cardiac morphology and right ventricular function after transcatheter closure of atrial septal defect (ASD) using the domesticmade occluder device. METHODS Fortyone patients with secundumtype ASD (15 male, 26 female) underwent transcatheter closure by using the domesticmade occluder device. Echocardiographic examinations were made immediately, 2 days, 3 months and 6 months after the closure. The right ventricular volume was calculated with plane area length method. RESULTS Two days after transcatheter closure the right atrium diameter, occipitofrontal diameter and leftright diameter of right ventricles decreased significantly (P<0.05,P<0.01). Right ventricular enddiastolic volume (RVEDV) reduced significantly (P<0.05). And right ventricular ejection fraction (RVEF) had a tendency to normalization. At 3 months RVEDV, RVESV and RVEF improved further. At 3~6 months the right cardiac size is stable on normal level roughly. CONCLUSION The changes of the right cardiac morphology and right ventricular function after transcatheter closure of ASD using the domesticmade occluder device were similar to that with the Amplatzer occluder device.The domesticmade occluder device not only can eliminate the abnormal shunt, but also can improve the highvolume load of the right heart.

参考文献/References

［1］ 张振远,秦永文,赵仙先,等. 用国产与进口双盘状封堵器治疗房缺的比较［J］. 心脏杂志,2004,2(16):80-81.

［2］ 雷芸,张伟华,丁云川,等. 国产封堵器治疗房间隔缺损疗效评价［J］. 中国介入心脏病学杂志,2003,11(2):68-70.

［3］ 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］ Meyer RA, Schwartz DC, Benzing G, et al. Ventricular septum in right ventricular volume overload［J］. Am J Cardiol, 1972,30:349-353.

［6］ 张玉顺,吴栋梁,张军,等. 房间隔缺损封堵术后右心形态和功能的变化［J］. 中国循环杂志,2002, 17(4):287-289.

备注/Memo

备注/Memo:
收稿日期：2004-12-30.
更新日期/Last Update: 2010-01-05