国产双盘型封堵器治疗室间隔缺损的远期效果

The effectand follow-up study on transcatheterclosure of ventricular septal defects with the homemade VSD occluder

目的:探讨国产双盘型室间隔缺损封堵器治疗室间隔缺损(VSD)的远期随访效果。方法:分析2003年9月至2007年3月间应用国产双盘状封堵器治疗的先心病室间隔缺损患者的临床资料,进行回顾性队列研究。出院前、术后1、3、6、12个月和1、2、3年定期复查心电图、心脏超声和胸部X片。结果:共有116例先心病室间隔缺损患者接受封堵治疗,年龄2.5～48(18.6±9.2)岁,体重8～66(28.6±16.2)kg。术中心室造影测量VSD大小为2.3～15.7(6.90±2.76)mm。植入封堵器直径为4～20mm。116例中,112例患者封堵成功,成功率96.8%。术后3个月随访86例,6个月随访72例,1年随访62例,2年随访42例,3年随访26例。随访超声心动图检查显示112例封堵器位置良好,形态正常,无血栓形成。随访期间无感染性心内膜炎、血栓栓塞和溶血等并发症。结论:国产双盘状封堵器治疗室间隔缺损是一种安全有效的微创介入治疗方法,操作简便,成功率高,近期和远期疗效可靠。

Objective：To evaluate the treatment effect of transcatheter closure of ventricular septal defect （ VSD ） with the homemade occluder device in mid -term and log-term follow-up. Methods ： From Novomber 2003 to Mar 2007, 116 patients （48 males, 68 femles） with perimembranous VSD underwent an attempt of catheter closure with the homemade occluder device specially disigned for the membranous septum. The mean age of patients was18. 6± 9.2 years （ranged from 2.5 to 48 years）; the mean weight of patients was 28. 6±16.2kg （ranged from 8 to 66 kg）; the diameters of the VSDs were 6. 90± 2. 76 mm （2. 3± 15. 7 mm） by left ventriculography. Occluder was released through right heart system follow up evaluations were made with chest X-ray and echocardiogram at 24 hours and 1, 3, 6 months, and 1,2, 3 years after implantation. Results ： The devices were deployed successfully in 112 patients. The technical success rate of the group was 98. 17%. There were no late complications. There were 86, 72, 62, 42, and 26 patients who were followed up 3 months, 6 months, I year, 2 years, and 3 years after the operation. Conclusion .Transcatheter method of VSD occlusion using homemade VSD occluder is safe and effective . It had a high technical success rate, satisfied and i＇eliable immediate and short-term results . Further clinical trials should be undertaken to assess the long-term safety and results