国产封堵器闭合先天性左向右分流型心脏病的疗效评价

EVALUATION OF CHINA-MADE OCCLUDER IN TRANSCATHETER CLOSURE OF CONGENITAL HEART DISEASES WITH LEFT-TO-RIGHT SHUNT USING

目的：评价国产封堵器闭合先天性左向右分流型心脏病的临床疗效、安全性。方法：在透视或（和）经胸超声心动图（TTE）指引下置入国产封堵器，术后24h，1、3、6、12个月及以后每年分别行TTE、心电图（ECG）和X线胸片检查评价治疗效果。结果：①51例动脉导管未闭（PDA）成功置入封堵器，成功率达100％。随访1～33个月所有病人健在，未发现残余分流、溶血及感染性心内膜炎等并发症；②103例房间隔缺损（ASD）中101例成功置入封堵器，成功率达98％。术中封堵器脱落1例，101例成功置入封堵器后即刻TTE显示97例（96％）封堵完全，4例（4％）存在微至少量残余分流。随访1～35个月所有病人均健在；③53例膜部室间隔缺损（VSD）闭合成功，成功率98％，术中未发生任何并发症。术后即刻造影无残余分流。随访1～26个月所有病人均健在。1例封堵器放置后出现完全性右束支传导阻滞，随访12个月没见恢复。结论：应用国产封堵器闭合先天性左向右分流型心脏病疗效可靠，使用安全。

Objective：To evaluate the treatment efficiency and safety of transcatheter closure of congenital heart diseases with left-to-right shunt by using China-made occluder. Methods：208 patients with congenital heart diseases with left-to-right shunt, including 103 atrial septal defects （ASD）, 51 patent ductus arteriosus （PDA）, 54 perimembranous ventricular septal defects （VSD）, confirmed by transthoracic echocardiography （TTE）, were implanted with China-made occluders percutaneously. TTE ,ECG and X-ray examination were applied to evaluate the efficacy at the time interval of 24 h, 1 month, 3 months,6 months, 12 months and yearly after the procedure. Result：（1）51 PDA were implanted with the occluders successfully, the success rate of the procedure was 100%. Following 1-33 months, all patients survived without residual shunt, haematolysis, infective endocarditis and any other complications. （2）In 103 patients with ASD, 101 patients were implanted with occluders successfully, and the success rate of the procedure was 98%. a patient＇s occulder fell in the procedure, while 97 （96 %） had complete the immediate closure and 4 （4 %） had trivial residual shunt with TTE after the procedure. 1-35 months following, all patients survival. At 1 year 1 patient had residual shunt. 2 patients had occluder displace and residual shunt. （3）In 54 patients with VSD,53 patients implanted occluders successfuly, the success rate of the procedure was 98%, no complication during the procedure. No residual shunt took place immediately （cardioangiograph） after the procedure. In the follow-up of 1-26 months, all patients survived. 1 patient had right bundle branch block after the procedure and still existed in the following 12 months. Conclusion： Transcather closure of congenital heart diseases with left-to-right shunt by using China -made occluder is safe and effective.