室间隔缺损并发畸形的介入治疗评价

Evaluation of transcatheter therapy of ventricular septal defects with other cardiac abnormities

目的评价同期应用介入治疗室间隔缺损(VSD)并发其他心脏畸形的可行性和治疗效果。方法全组13例,年龄3～42(9±17)岁。经临床、心电图、X线及超声心动图诊断为VSD并发其他心脏畸形,其中7例为房间隔缺损(VSD),5例为动脉导管未闭(PDA),1例为3种心脏复合畸形(VSD、ASD及PDA)。介入治疗顺序先行VSD封堵术,其次PDA封堵术,最后行ASD封堵术。术后1d、1个月、6个月及1年行经胸超声心动图(TTE)、ECG及X线检查评价治疗效果。结果13例同期介入治疗均获得成功,术中未发生任何重要并发症。术后1d、1个月、6个月及1年TTE显示室间隔及房间隔无残余分流。并发PDA患者,应用PDA封堵器关闭术后10min降主动脉侧位造影,无残余分流。结论同期介入治疗ASD并发某些心脏畸形是一种有效、安全、简便可行的方法。

AIM: To evaluate the efficiency and feasibility by transcatheter therapy of ventricular septal defects(VSDs) with other cardiac abnormities . METHODS: 13 VSDs pathents at a median age of 9±17 years (range 3.0 to 42.0) .with other abnormities( atrial septal defect 1, patent ductus arteriosus 5,atrial septal defects and patent ductus arteriosus 1) were treated in or during with the same procedure by combined transcatheter techniques(VSDs closure first,patent ductus arteriosus second,atrial septal defects last) . Transthoracic echocardiography(TTE),ECG and X-rays examination were done 1 d,1months、6 months and 1 year after the procedure to evaluate the efficiency. RESULTS: The success rate of transcatheter therapy of ventricular septal defects with other cardiac abnormities was 100%. No complications occurred during the procedure. No residual shunts were found at atrial levels,ventrial levels and great artery levels 3 d after the procedure and in 1 month、6 months and 1 year follow-up. X-ray examination showed that pulmonary vascularity and heart size were improved. CONCLUSION: Transcatheter therapy of VSDs with some other cardiac abnormities in or during with the same procedure by combined transcatheter techniques was an effective, feasible and safe nonsurgical method.