经导管介入治疗瓦氏窦瘤破裂的临床疗效及其安全性

Transcatheter closure of ruptured aneurysm of valsalva sinus

目的探讨经导管介入治疗瓦氏窦瘤破裂的临床疗效与安全性。方法用导管法对1例瓦氏窦瘤(右冠窦)破入右心房患者进行封堵治疗。术后定期随访,复查心脏超声及心电图等,对封堵术前后心脏杂音、各心腔压力、心腔大小变化等进行回顾性分析研究。结果用12/14mm的国产PDA封堵器成功封堵。术后即刻心脏杂音消失,右心房、右心室及肺动脉压力分别由术前的21/10、52/2、50/14mmHg下降为14/5、34/0、33/15mmHg,左心室内径术前为57mm,术后第3天复查为49mm;无并发症发生。结论经导管介入治疗瓦氏窦瘤破裂是一项安全、有效的新技术,对适合进行介入治疗的患者,可以取代外科手术治疗。

Objective To discuss the clinical effects and security of transcatheter closure of ruptured aneurysm of valsalva sinus （RAVS）. Methods A 28-year-old male patient admitted in our hospital on Septemas ruptured aneurysm of right valsalva sinus drained into right atrium, and accepted transcatheter closure. During the regular one-month interval follow-up, echocardiography and ECG were performed. Cardiac murmur, pressure and size of each chamber before and after transcatheter closure were analyzed retrospectively. Results Cardiac murmur disappeared right after successful occlusion with a 12/14 mm domestic-made PDA occluder, and the pressure of right atrium, right ventricle and pulmonary artery decreased respectively from 21/10 mmHg, 52/2 mmHg and 50/14 mmHg to 14/5 mmHg, 24/0 mmHg and 33/15 mmHg. Left ventricular internal diameter decreased from 57 mm before transcatheter occlusion to 49 mm three days after occlusion. No complications occurred. Conclusion Transcatheter closure of RAVS is safe and effective, and can substitute surgical operation in some patients of RAVS.