国产封堵器用于245例先天性心脏病介入治疗的疗效评价

Catheter closure of congenital heart dieases using a new homemade occluder

[目的]观察国产封堵器介入治疗先天性心脏病的临床疗效及安全性。[方法]先天性心脏病患者, 分别包括膜周部室间隔缺损、房间隔缺损和动脉导管未闭,经超声心动图检查局部解剖结构满足封堵条件。在局麻或全麻下对膜周部室间隔缺损、房间隔缺损和动脉导管未闭患者行经导管国产封堵器介入治疗,手术中经胸超声心动图和X线监测。术后随访13个月。[结果]堵闭操作技术成功率98．3％。有2例患者手术后3-7 d 发生Ⅲ度房室传导阻滞,1例发生心源性晕厥;安装临时起搏器3 d后心率正常。3例患者术后发生溶血,对症处理后消失。[结论]超声心动图是筛选先心病患者进行介入治疗的有效手段。介入治疗先天性心脏病的操作简单,疗效确切,并发症低,恢复快,是治疗先天性心脏病的理想手段之一。用国产封堵器介入治疗,效果良好。

[Objective] To evaluate the effectiveness and safety of transcatheter clousure of congenital heart dieases using homemade occluder. [Methods] Patients clinically diagnosed as CHD were recommended for further transthoracic echocardiographic assessment using multiple standard views. All procedures were performed under local or general anesthesia. Transthoracic echocardiography and X ray were used to monitor the procedure. [ Results] The successful rate of device implantation was 98.3%, two patientes developed Ⅲ degree A-V block 3 - 7 days after the procedure, and EKG became LBBB 3 days after the temporary pace making. Hemolysis was observed in three patientes, and they recovered 7 days after medical treatment. [Conclusion] Transthoracic echocardiography is effective in screening patient for catheter closure of CHD. Transcatheter occlusion shows a promising therapeutic effect on CHD due to its low ratio of residual shunt and few serious complications.