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|本期目录/Table of Contents|

介入治疗房间隔缺损并发肺动脉瓣狭窄的临床评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第3期
页码:
288-289
栏目:
介入治疗
出版日期:
2005-05-05

文章信息/Info

Title:
Interventional treatment for pulmonary valve stenosis associated with secundum atrial septal defect
作者:
韩秀敏;  朱鲜阳;  邓东安;  侯传举;  盛晓棠;  崔春生;  全薇
沈阳军区总医院先心病内科，辽宁 沈阳110016
Author(s):
HAN Xiumin;  ZHU Xianyang;  DENG Dongan;  HOU Chuanju;  SHENG Xiaotang;  CUI Chunsheng; QUAN Wei
Genetal Hospital of Shenyang Army, Shenyang， Lioaning 110016,China
关键词:
房间隔缺损; 肺动脉瓣狭窄; 介入治疗
Keywords:
atrial septal defect ;  pulmonary valve stenosis ;  interventional therapy
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 评价介入治疗房间隔缺损并发肺动脉瓣狭窄的近中期疗效。方法 11 例患者，年龄3～53（16±15）岁。超声心动图测量房间隔缺损最大直径为8~38（21.7±10.8）mm， 1例心房水平显示双向分流，10例呈左向右分流，均并发有不同程度的肺动脉瓣狭窄。先行球囊肺动脉瓣成形术（PBPV），其中6例采用肺动脉瓣单球囊，5例采用Inoue二尖瓣球囊扩张；而后置入Amplatzer型房间隔缺损封堵器闭合缺损，选择的封堵器直径为10~40（ 22.9±11.5）mm。结果 同期行介入治疗均成功，PBPV术后即刻右室收缩压由术前77±18 mm Hg降至39±7 mm Hg , 肺动脉至右心室跨瓣压差由术前47±18 mm Hg降至9±5 mm Hg(P< 0.01)。术后超声心动图随访3～67个月，疗效满意，房间隔未见残余分流。结论 介入方法治疗房间隔缺损并肺动脉瓣狭窄安全、有效。
Abstract:
AIM To evaluate the short and longterm efficacy of percutaneous balloon pulmonary valvuloplasty and atrial septal defect closure in the treatment of pulmonary valve stenosis associated with secundum atrial septal defect. METHODS 11 patients of age 16±15 (ranged from 3～53)years were studied. One of them has two way shunt in atrial septal . Five patients underwent pulmonary valvuloplasty with unifoliate balloon and 6 patients with Inoue balloon initially. Atrial septal defect was closed later using Amplatzer septal occluder. RESULTS All of 11 patients were treated successfully. After therapy, right ventricular systolic pressure decreased from 77±18 mm Hg to 39±7 mm Hg and systolic pressure gradient across the pulmonary valve decreased from 47±18 mm Hg to 9±5 mm Hg immediately( P<0.01). Followed up 3～67 months by echocardiography, no residual shunt of atrial septal was found in 11 patients. CONCLUSION Interventional therapy for pulmonary valve stenosis associated with secundum atrial septal defect at the same time is safe and effective.

参考文献/References

［1］朱鲜阳，钱武扬，张玉威，等. 经皮球囊肺动脉瓣成形术治疗先天性肺动脉瓣狭窄20例报告.临床心血管病杂志，1992,8:24-26.

［2］韩秀敏，朱鲜阳，张玉威，等. 经皮球囊肺动脉瓣成形术133例. 心脏杂志 2001，13：481-483.

［3］邓东安，侯传举，韩秀敏，等. 继发孔型房间隔缺损介入性封堵术27例临床报告. 中华心血管病杂志，2000，28：99-111.

［4］Nugent AW,Menahem S,Goh TH,et al. Device closure of an atrial septal defect following successful balloon valvuloplasty in a neonate with critical pulmonary valve stenosis and persistent cyanosis［J］. Pediatr Cardiol,2000,21:170-171.

［5］郑可，韩玲，金梅，等. 伴房间隔缺损或卵圆孔未闭的肺动脉瓣狭窄99例分析.中华儿科杂志， 2000，40：503.

备注/Memo

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