嵴内型室间隔缺损的介入治疗

Interventional Treatment of Intracristal Ventricular Septal Defect

目的：探讨嵴内型室间隔缺损（IVSD）介入治疗的安全性和有效性。方法：50例室间隔缺损（VSD）介入治疗患者中，有10例术前经胸超声心动图（TTE）确定为IVSD，其中男8例，女2例，年龄4-44岁（平均21岁）。术中常规左心室造影，以明确IVSD的诊断；符合通过VSD建立股动静脉轨道，应用7-9F输送鞘释放封堵器。8例采用国产动脉导管未闭封堵器，型号为6-8mm或14-16mm，2例采用国产对称性室间隔缺损封堵器，型号为7-10mm。分别于术后3、6和12个月时心电图和超声心动图。结果：10例患者左心室造影显示右后向左前分流束，均封堵成功。术后1例出现微量主动脉瓣返流。术后随访10例患者均无异常改变。结论：嵴内型室间隔缺损介入治疗安全、手术成功率高，长期疗效有待于进一步观察。

Objective：To assess the efficacy and safety of interventional treatment for intracristal ventricular septal defect （IVSD）. Methods：Of 50 patients had Interventional treatment of ventricular septal defect, 10 patients （8 men and 2 women） had IVSD proved by trans-thoracic echography （TTE） with the age ranged from 4 to 44 years old （mean 21 years）. All patients underwent left ventriculography routinely to identify the diagnosis of IVSD and femoral A-V track was established via VSD. The 7-9F sheath-canuula were deployed via femoral vein,domestic-made patent ductus arteriosus occluder （6-8mm or 14-16mm） was used in 8 patients and symmetric ventricular septal defect occluder （7-9mm） was used in 2 patients. Follow-up with EKG and echography were undertaken 3,6 and 12 months after the procedures. Results： The IVSD in all 10 patients were successfully occluded,showing right posterior to left anterior shunt by left ventriculography. Minimal aortic valve regurgitation occurred only in 1 patient after the procedure. Conclusions： Interventional treatment for intracristal ventricular septal defect is an effective and safe approach. The success rate was high, yet further evaluation is needed for assessing the long term efficacy.