室间隔缺损介入治疗的临床分析

Trans catheter occlusion of ventricular septal defects

目的评价经导管介入治疗室间隔缺损(VSD)的疗效、安全性及其并发症治疗。方法112例VSD患者经超声心动图显示,膜部室间缺损(VSD)110例室间隔膜部缺损合并肌部缺损(Rogers病)1例,法乐氏四联症术后残余漏1例,5例合并房间隔缺损,3例合并动脉导管未闭,5例合并膜部瘤。2例室间隔缺损上缘距主动脉瓣1mm左右,其余均在1mm以上。室间隔缺损直径2.5-13mm(6.12±2.36mm)。所有患者无严重的肺动脉高压或右向左分流,均使用国产先健科技生产的封堵器。结果112例造影测量值为2.2-13.5mm(6.54±2.68)mm,选择的封堵器直径为4-16mm(7.34±1.87)mm。107例封堵成功,10分钟后造影或超声示无残余分流,5例患者封堵失败,8例术中出现室上性心动过速,无临床自觉症状,3例术后出现右束支传导阻滞,2例出现心包积血,1例出现脑栓塞,6例出现心前区疼痛,2例头疼明显,1例封堵伞脱落。封堵成功患者随访1-12个月,无其它并发症和残余分流发生。结论经导管治疗室间隔缺损是安全有效的方法之一,其并发症少,经临床积极治疗,效果良好。

Objective To evaluate the effectiveness safety and treatment complication of transcatheter closure of ventricular septal defects. Methols 112 patients were selected by echocardiography, has VSD both in perimembranous and in muscular. One patient was F4 which had remnants disclosure after surgery. 5 patients has ASD 3 patients had PDA and 5 patients has aneurysm formation at the same time . The distance of VSDS edge to aortic valve was about 1 mm in two patients , others was more than 2 mm . The diameter of VSD was about 2. Smm -13mm（6.12 ±2.36mm） . All patients had no severe pulmonary hypertension or fight to left shunt. All cases was closed by VSD occluded made in China. Results The VSD diameter ranged from 2.2 - 13.5mm（6.54 ±2.68mm） . The device diameter ranged from 4 - 16（7.34 ± 1. 877mm） . After application of the prosthesis there was no residual shunt in 107 patients . 5 cases was failure . There was supraventricular tachyc in 8 patients, but had no symptom. 3 patient developed left bundle breach block. Two patient developed bydropspericardic , one patient developed cerebral thrombosis. 6 patients bad ache of before breast and 2 patients bad headache after surgery . No other complications were observed in 1 - 12 months follow up. Conclusion The Transcatheter closure of VSDappears to be a safe and effective method . It has less complication and effective.