先天性心脏病复合畸形的介入治疗

Interventional Treatment for Multiple Defects of Congenital Heart Disease

目的探讨介入治疗小儿先天性心脏病(CHD)复合畸形的可行性和疗效。方法对CHD复合畸形患儿10例施行联合介入治疗,其中房间隔缺损(ASD)并肺动脉瓣狭窄(PS)2例,室间隔缺损(VSD)并动脉导管未闭(PDA)4例,PDA并PS 2例,ASD并PDA 2例。结果7例1次治疗成功,余3例中2例分2次治疗,1例8个月患儿,因其在最初0.5年随访中发现VSD明显缩小,故先封堵了PDA,目前正在随访中。成功率100%,无严重并发症。经1个月-3年随访,患儿心脏缩小,心脏功能改善。结论在病例选择恰当情况下,对小儿CHD复合畸形进行介入治疗是安全、可行的。

Objective To evaluate the feasibility and efficacy of transcatheter treatment for multiple defects of congenital heart disease （CHD） with the same cardiac catheterization in pediatric patients. Methods Ten children（6 boys and 4 girls） with multiple cardiac defects underwent interventional treatment between January 2003 and April 2006. Their ages ranged from 8 months to 8 years. Two patients had percutaneous balloon pulmonary valvuloplasty（PBPV） and a successful Amplatzer septal occluder or homemade device closure of a secundum atrial septal defect（ASD） at one procedure. Two patients had PBPV and occlusion of the patent ductus arteriosus（PDA） with Cook detachable coil or Amplstzer septal ocduder device. Two patients had both ASD and PDA occlusion; 4 patients had both VSD and PDA, and the remaining boys had PDA and a closure of membranous ventricular septal defect with the same catheterization. Results Intervention was achieved in all 10 patients. There were no severe complications. Follow- up ranged from i months to 3 years,and it showed a good therapeutic efficacy. Conclusion Interventional treatment for multiple defects of CI-ID is an effective and safe technique in selected patients.