国产封堵器对膜部瘤型室间隔缺损的治疗

Clinic research on membranous aneurysm ventricular septal defect treated with domestic occluder

目的:报道使用国产封堵器介入治疗膜部瘤型室间隔缺损(VSD)的体会。方法:经彩色多普勒超声心动图和左心室造影证实有适应证的并发膜部瘤形成的VSD患者20例,行介入封堵治疗,并根据膜部瘤形态进行分型,制定封堵策略,选择封堵器和封堵方式。结果:①20例患者均封堵成功,技术成功率达100%,无介入并发症发生;②20例膜部瘤呈4种类型,漏斗型8例、囊袋型5例、菜花型5例、弯管型2例;③根据缺损口大小及膜部瘤类型分别使用细腰大边型、非对称型、对称型封堵器均封堵成功;④改良猪尾导管在膜部瘤型VSD封堵术中效果显著。结论:国产封堵器介入封堵膜部瘤型VSD患者安全、有效、并发症少、费用低,可作为有封堵适应证VSD患者的首选方案。

Objective：To report the experience about membranous aneurysm ventricular septal defect （VSD） treated with domestic occluder. Method.. Twenty patients with membranous tumor-shaped VSD confirmed by Doppler echocardiogram and left ventriculography. To exert interventional occlusion, VSD was typed according to the shape of membranous aneurysm, then occlusion strategy was determined and occluder was chosed. Result ： ① Occlusion was successfully performed in 20 patients without interventional complication. ② There were 4 types in 20 cases.. 8 funnel-shaped, 5 sac-shaped, 5 cauliflower-shaped, 2 corner-shaped ; ③ Slender waist-big edge, asymmetric or symmetric occluder were used respectively according to the size of septal and the type of membranous aneurysm. ④ The effects of modified Pig tail catheter using in the occlusion of membranous tumor-shaped VSD were significant. Conclusion：It is a safe, effective and with lower complication and cost that membranous anenrysm VSD treated with domestic occluder, and can be the first choose of patients with VSD.