摘要
目的探讨经心室穿刺封堵婴幼儿非肌部室间隔缺损(VSD)的临床效果。方法2007年4月至2008年2月,治疗39例非肌部VSD病儿,男16例,女23例。年龄12~36个月,平均(14.5±7.8)个月;体重8.5~18.0kg,平均(12.4±2.3)kg。其中膜周部VSD34例、干下型3例、嵴内型2例。缺损直径3.0~11.0mm,平均(6.1±2.0)mm。均接受非体外循环下经右心室穿刺封堵VSD治疗。结果全组均无需输血。37例封堵成功,2例因发生中度主动脉瓣反流改行直视手术。置人封堵器直径4~12mm,平均(8.24-2.0)mm。术后膜周部VSD者中三尖瓣反流程度减轻3例,新出现微量至轻度三尖瓣反流8例;6例出现不完全性右束支传导阻滞。术后住院3~5d,平均(3.4±0.4)d。结论经心室穿刺行VSD封堵术对婴幼儿非肌部VSD而言是一种有效和安全的治疗手段。
Objective To evaluate the effect of perventricular device closttre of non-ranseular ventricular septal defects (VSDs) in infants. Methods From April 2007 to February 2008, 39 patients with non-mnscular VSDs were received off pump surgical treatment, perventricular device closure were used for all the patients. There were 16 males and 23 females with mean age of ( 14.5 ± 7.8) months (12 to 36 months and mean weight of (12.4±2.3) kg(8.5 to 18.0 kg). There were 34 perimembranons and 5 subaterial VSDs. The diameter of defects were 3 . 0 to 11 mm [mean (6.1±2.0) mm]. Results Thirty-seven (94.9%) VSDs were successfully closed, while two were repaired under cardiopulmonary bypass (CPB) instead ef device closure because of the corrtphcation of moderate aortic regurgitation. The diameter of occluders were 4 to 12 mm [mean (8.2 ± 2.0) mm]. The tricuspid regurgitations decreased after operation in 3 patients with perimembranous VSDs, while the closure caused new mild or trace tricuspid regurgitations in 8 patients. Six patients with perimembranons VSDs acquired the incomplete right bundle branch blocks after device closure. The length of hospital stay was 3 to 5 days [ mean (3.4 ± 0.4 ) ] after operation and no patient had blood transfusion. Conclusion Perventricular device closure is probably an effective and safe treatment for non-museular VSDs in infants.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2008年第6期367-369,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
国家科技支撑计划项目资助(2006BAI01A08)
关键词
室间隔缺损
心脏外科手术
穿刺
Heart septal defects, ventricular Cardiac surgical procedures Punctures