经导管介入治疗先天性心脏病疗效分析

Therapeutic effect of domestic ocduder on patients with congenital heart diseases

目的:探讨介入治疗先天性心脏病近期临床疗效。方法:对662例先天性心脏病患者,其中单一病变605例,复合病变57例;先天性心脏缺损在经胸彩色超声心动图(TTE)及X线影像指导下,经皮沿导丝经传送鞘管将合适的封堵器至缺损处行封堵;肺动脉瓣狭窄采用Inoue球囊或聚乙烯球囊行肺动脉瓣球囊扩张术。结果:TTE测量房间隔缺损为(16.8±7.6)mm,所用封堵器为(20.3±8.8)mm;左室造影测量室间隔缺损直径为(6.7±3.4)mm,封堵器(8.9±4.2)mm;造影测量动脉导管未闭最窄处直径为(6.6±3.2)mm,所选用封堵器直径为(12.7±4.4)mm;662例先天性心脏病患者中介入成功者627例,35例未成功,成功率94.7%,成功者术后即刻未见明显分流;肺动脉瓣球囊扩张术后跨瓣压差均降至2.66kPa以下。结论:先天性心脏病经皮介入治疗操作简单、成功率高、安全可靠、近期临床疗效好。

Objective：To evaluate the therapeutic effect of domestic occluder device on patients with congenital heart diseases. Method： Six hundred and sixty-two patients were treated with the occluder devices through angiography and transthoracic echocardiography （TTE）. Result： The atrial septal defect （ASD） diameter was （ 16.8 ± 7.6）mm by TTE. The diameter of the occluder selected was （20.3 ± 8.8）mm. The ventricular septal defect （VSD） diameter was （6.7 ± 3.4）mm measured by left ventricular angiography and the diameter of occluder selected was（8.9 ±4.2）mm. The narrowest diameter of the patent ductus arteriosus（PDA） was （6.6±3.2）mm by angiography. The diameter of occluder selected was （12.7±4.4）mm in aortic side. The successful rate was 95.8% . No residual shunts were found in all successful cases after the procedure. And after the percutaneous balloon pulmonary valvuloplasty （PBPV）, the systolic pressure gradient across the pulmonary valve all decreased to lower than 2.66 kPa. Conclusion;The therapy of congenital heart diseases with domestic occluder is safe and reliable and has high achievement ratio .