国产封堵器治疗房间隔缺损的应用

Percutaneous transcatheter closure of atrial septal defect using domestic septal occluder

目的:评价应用国产封堵器治疗继发孔型房间隔缺损(ASD)的初步疗效.方法:31例ASD患者,ASD直径为10～34(19±8)mm.所有患者在X线及经胸超声心动图(TTE)监视下经导管置入国产房间隔封堵器.治疗术后及术后3个月随访超声心动图、胸片、心电图,观察对血流动力学及心功能的影响.结果:全组手术成功率为100%,术后即刻及随访未见残余分流.与术前比较,三尖瓣口、肺动脉瓣口血流峰值明显降低,二尖瓣口血流峰值增加(P＜0.05),术后及随访期右心房、右心室内径缩小,右室射血分数早期下降,后期无明显变化.左室功能无明显变化,无出现新的心律失常和脑栓塞等并发症.结论:国产房间隔封堵器可有效治疗ASD,操作方便,手术成功率高,疗效可靠.有效改善右心高容量负荷状态.

AIM： To evaluate the therapeutic effect of transcatheter closure of secundum atrial septal defect （ASD） using domestic septal occluder. METHODS： Thirty one patients aged 2 to 64 years were treated with domestic septal occluder through the percutaneous procedure under fluoroscopic and transthoracic echocardiographic minitoring（TTE）. The diameters of ASD were 10 -34（ 19 ± 8）mm. Echocardiography, chest X ray and electrocardiography were performed before and after transcatheter closure and during the follow-up. RESULTS：The success rate of the operation was 100%. No residual shunts were found in all the patients right after the procedure and during the follow-up. The peak blood velocity of tricuspid valves and pulmonary aortic valves was significantly decreased after operation and during the follow-up （P 〈 0.05 ）, while that of mitral valves was significantly increased （P 〈 0.05 ）. RA and RV diameters were reduced markedly right after the procedure and further decreased during the follow-up. RVEF was decreased at early stage and remained stable during the follow-up. LV function was not changed significantly. No complications such as arrhythmia, cerebral embolism occurred. CONCLUSION：Domestic septal occluder is suitable for most ASD patients and the operation is simple and effective with good chance of success.