微创非体外循环房间隔缺损封堵术的临床应用

Closure of atrial septal defect with occluder by minimally invasive and non-extracorporeal circulation ways

目的总结我院微创非体外循环房间隔缺损封堵术的临床应用经验。方法对10例继发孔型房间隔缺损(ASD)患者进行微创非体外循环房间隔缺损封堵术。全麻下右侧胸骨旁第4肋间4-6cm切口,食管超声(TEE)测量房间隔缺损最长径,选择适当封堵伞,TEE监测下释放封堵伞,了解有无残余分流等异常。结果10例患者手术均成功,术中未发生任何并发症,术后复查心彩超未见残余分流。2例出现术后高血压,给与降压对症治疗,1例中度肺动脉高压复查心彩超肺动脉压明显下降,术后右心大小较术前有减小。结论微创非体外循环房间隔缺损封堵术是一种微创手术治疗方法,值得推广、发展。

Objective To review the experience of atrial septal defect（ASD） occluder by minimally invasive and non-extracorporeal circulation ways. Methods From April to August in 2006,10 patients with artrial septal defect were treated by minimally invasive and non-extracorporeal circulation ways. All patients were anaesthetized and a 4-6 cm long incision was made in the 4th intercostals space of right side of sternum. The occluder was selected and released under the transesophageal echocardlography （TEE）. Results All patients were successfully occluded at once. No complications happened during the procedure, no residual shunt was found by TEE. Conclusion Atrial septal defect with occluder by minimally invasive and non-extracorporeal circulation ways is microinvasive surgery operation, worthy of clinical application.