先天性心脏病介入治疗的严重并发症分析及其防治

Prevention and Management of Severe Complications Induced by Interventional Therapy for Congenital Heart Disease

目的:探讨先天性心脏病(先心病)介入治疗中和治疗后严重并发症的发生率、原因及防治措施。 方法:对2 318例4种常见先心病施行了介入治疗,其中动脉导管未闭(PDA)封堵术850例(PDA封堵术组);房间隔缺损(ASD)封堵术818例(ASD封堵术组);肺动脉瓣球囊成形术548例(肺动脉瓣球囊成形术组);室间隔缺损封堵术102例(室间隔缺损封堵术组)。对介入治疗中和治疗后发生的34例严重并发症和2例死亡的患者作回顾性分析。 结果:严重并发症总发生率为1.47％(34/2 318),其中PDA封堵组为1.41％(12/850);ASD封堵组为1.47％(12/818);肺动脉瓣球囊成形术组为0.91％(5/548);室间隔缺损封堵术组为4.90％(5/102)。总死亡率为0.09％(2/2 318),均为肺动脉瓣球囊成形术组,占0.36％(2/548);紧急手术为0.35％(8/2 318),择期手术为0.13％(3/2 318)。 结论:先心病介入治疗是一种安全、有效、严重并发症及死亡率低的非手术方法。术后应作严格随访,尤其警惕ASD封堵术后晚期并发症的发生。

Objective: To approach the incidence, cause, treatment and prevention of severe complications developing during or after in-lerventional therapy for congenital heart disease at a single institution.Methods: Interventional procedures of congenital heart disease were performed in 2 318 patients. Among them, 36 patients ( 34 had severe compli cations and 2 died) were retrospectively analyzed.Results: The overall severe complication rate was 1. 47% (34/2 318). The procedure-related mortality rate was 0. 09% (2/ 2 318). Emergency cardiovascular surgery rate was 0. 35 % (8/2 318) .Conclusions: The severe complication and mortality rates of interventional therapy for congenital heart disease are low. It is a safe and efficient nonsurgical method. Careful long follow-up is necessary after procedure.