国产对称双盘状封堵器经导管治疗室间隔缺损21例

China made two-disk-like VSD occluder for transcatheter closure of 21 patients with ventricular septal defects

目的:分析国产对称双盘状封堵器经导管治疗室间隔缺损(VSD)的疗效.方法:21例,全部为膜部室间隔缺损,年龄3.0～35.0(7.6±8.4)岁.VSD左室面直径为2.2～12.0(6.2±4.2)mm.经6F-10F传送鞘置入国产对称双盘状封堵器,封堵后即刻行左心室造影,术后1 d、1、6及12月行超声心动图检查观察有无残余分流.结果:封堵器植入成功20例,植入技术成功率95%.术后即刻左心室造影示4例(20%)存在微～少量残余分流,16例(80%)封堵完全无残余分流.术后24～48 h超声心动图示分流完全消失19(95%)、微～少量残余分流1例(5%).1例封堵术后3 d发生一过性Ⅲ度房室传导阻滞,经过4～10 d内科保守治疗治愈.1月超声心动图所有病例未见残余分流.结论:应用国产双盘状封堵器治疗VSD是一种安全有效的介入方法,操作简便,成功率高,近期疗效可靠.

AIM： To analyze the efficiency of transcatheter closure of ventricular septal defect （VSD） using the domestic made two-disk-like VSD occluder device. METHODS： Twenty one patients with membranous VSD underwent attempted transcatheter closure of a VSD using the domestic made two-disklike VSD occluder device at a median age of 7.6 ± 8.4（3.0 -35.0）years . The mean VSD diameter at its left ventricular side was 6.2±4.2（2.2 - 12.0） mm . A 6F - 10F long sheath was used for delivering the device. The left ventricular graphies （LVG） and transthoracic echocardiography （ TTE ） were performed to evaluate the immediate results after the procedure. TTE and ECG were performed 1 d, 1, 6 months and 1 year after the procedure to evaluate the efficiency. RESULTS： The success rate of the group was 95% （20 of 21 ）. LVG showed that 16（80% ）patients had complete immediate closure, 4 （20%）had a small shunt immediately after the procedures. Within 24 -48 h, color doppler revealed complete closure in 19（95% ） patients and a small shunt in 1 patient （5%）. One patient suffered from temporary m atrial ventricular block and returned to normal 4 - 10 d after medication. Doppler revealed that there were no residual shunts in all patients 1 months after the procedure. CONCLUSION： Transcatheter occlusion of VSD using domestic-made two-disk-like VSD occluder is safe and effective. It has a high success rate and satisfactory short term results. Further clinical trials are underway to assess the longterm safety and results.