先天性左向右分流心脏病介入治疗158例报告

Intervenienttreatmentofcongenitalheartdiseaseswithleft┐to┐rightshuntin158cases

应用Ｐｏｒｓｔｍａｎｎ泡沫塞子、Ｒａｓｈｋｉｎｄ双伞闭合器、Ｌｏｃｋ蛤壳闭合器和Ｓｉｄｅｒｉｓ钮扣装置经导管关闭先天性动脉导管未闭（ＰＤＡ）、心室间隔缺损（ＶＳＤ）和心房间隔缺损（ＡＳＤ）共１５８例。除首例巨大ＡＳＤ外，全部关闭成功。其中１５２例左向右分流完全阻断，仅５例有少量残余分流。随访１～９２个月，无一例发生关闭物移位。作者认为，经导管关闭ＰＤＡ、ＶＳＤ和ＡＳＤ是一种安全、可行和有效的治疗方法，并对手术适应证及有关问题作了较深入的讨论。

Thepurposeofthisstudywastoassesstheefficacy,feasibilityandprospectsofinter-venientmethodstotreatcongenitalheartdiseaseswithleft-to-rightshunt.BetweenJanuary1988andAugust1995,158patientsunderwenttranscatheterclosureofcongenitalpatentductusarteriosus(PDA),ventricularseptaldefect(VSD)andatrialseptaldefect(ASD)withthePorstmannfoamplug,theRashkinddouble-umbrelaoccluder,theLockclamsheloccluderandtheSiderisbuttoneddevice.Successfulocclusionwasachievedin150PDA,6VSDand2ASDexceptanenormousPDAandalargeASDpatients.Theleft-to-rightshuntwascompletelystoppedin152ofthe157patients,andsmalresidualshuntsweredetectedbycolorDopplerstudiesin4VSDcasesusingthebuttoneddevices.Noprosthesisdisplacementwasnotedduringfolow-upof1to92months.ItisconcludedthattranscatheterclosureofPDA,VSDandASDissafe,feasibleandeffectiveandhasagoodprospects.