经导管封堵治疗先天性继发孔型房间隔缺损的疗效

Transcatheter closure for congenital secondum atrial septal defect

目的观察国产房间隔缺损封堵器治疗继发孔型房间隔缺损的疗效,以及对手术适应证的体会。方法对58例继发孔房间隔缺损术前超声心动图所见与介入性治疗结果进行分析。结果除1例前缘短小并下缘缺如者外,余57例均成功封堵。结论多数继发孔房间隔缺损虽属中央型,但缺损缘短小或缺如者多见。带孔封堵器为合并严重肺高压的房缺患者提供了新的治疗机会。

Objective To observe the efficacy of transcatheter closure for congenital secondum atrial septal defect (ASD) with Amplatzer occluder, and to introduce the experience in identifying the operative indication. Methods Fifty-eight patients, 16 male and 42 female, underwent interventional therapy for congenital secondum atrial septal defect, aging 6 to 60 years (average 29±14). Before operation, all patients underwent physical examination, chest X-ray examination, Doppler and 2-dimensional echocardiography, and diagnosed as congenital secondum atrial septal defect. The diameter of atrial septal defect was 5 to 36 mm, averaging (22.29±7.06). According to the interventional results, all cases were analyzed and optimized. Results All patients had successful transcatheter closure except one patient with deficiency of the anterior rim and absence of the inferior rim. Conclusion Though most ASD is of central type, deficient or absent in rims are common. Proper rims are the warrant of success in closing ASD with Amplatzer occluder. The Amplatzer occluder with fenestration provides a new method for patients with ASD complicated with severe pulmonary hypertension.