国产封堵器闭合膜部室间隔缺损的临床应用

Preliminary clinical application of home-made occluder for transcatheter closure of peri-membranous VSD

目的评价国产封堵器经导管闭合室间隔缺损(VSD)的可行性及疗效。方法16例患者经临床体检、心超诊断为先天性心脏病,膜周部VSD。术前超声测量缺损直径5～12 mm。在X线透视和经胸超声引导下通过F 6～8长鞘置入封堵器。结果左心室造影测量VSD直径为2～12 mm。植入封堵器直径为4～14 mm。封堵器到位后15 min左心室造影14例无分流,2例少量分流。术后1周经胸超声检查无分流,术中及术后无并发症。结论应用国产封堵器闭合膜周部VSD安全、有效。远期疗效尚需进一步随访。

Objective To evaluate the feasibility, efficacy and safety of transcatheter closure for perimembranous VSD using home-made occluder. Methods Transcatheter closure was attempted in 16 patients with peri-membranous VSD at range from 5 - 12 mm diagnosed by echocardiography and left ventriculography preoperatively. The mean VSD narrowest diameter was （7.4 ±1.89）ram （range 2 - 12 mm）by echocardiography and a 6 - 8 F delivery sheath was advanced across the peri-membranous VSD over a wire from femoral vein approach to place the occluder with diameter 4 - 14 mm. Left ventriculography and transthoracic echocardiography were repeated to assess the efficacy of the closure, 15 min after the procedure. Results The mean VSD narrowest diameter was（5.83 -4- 2.07）mm（range 2 - 12 ram）measured by left ventriculography. The devices were successfully deployed in all patients. The diameter of occluder was（6.29 ± 0.94）mm（range 4 - 14 mm）. There was a trivial residual shunt in 2 patients shown by left ventriculography after the procedure. No shunt was found by the transthoracic echocardiography 1 week later. No complication occurred in all patients. Conclusion Transcatheter closure of peri-membranous VSD with home-made occluder is safe and effective. The long-term efficacy is still to be determined by follow-up.