钮扣式补片治疗先天性室间隔缺损

Outcome and follow-up of occlusion of congenital ventricular spetal defect with buttoned device

目的探讨经皮钮扣式补片法治疗先天性室间隔缺损（ＶＳＤ）的可行性及经验。方法膜周型ＶＳＤ１１例，干下型ＶＳＤ２例，肌部ＶＳＤ１例，应用Ｓｉｄｅｒｉｓ钮扣式补片法治疗。结果成功１０例，均为膜周型ＶＳＤ，失败４例。手术成功患者术后造影左向右分流消失或减弱，随访３个月至３年，彩色多普勒血流显像证实ＶＳＤ闭合，失败４例，除了１例室缺口直径较原先增大外，无其他手术并发症。结论钮扣式补片法对治疗ＶＳＤ是可行的。

Objective To explore the possibility and experiences of using catheter base buttoned device to occlude congenital ventricular septal (VSD). Methods 14 cases of VSD, including 11 cases of membranous defect, 2 cases of supracristal defect and 1 case of muscular defect, were catheterized for closures of VSD with buttoned device. Results 10 cases of membranous defect were successfully closured with buttoned device, in which there was no or minimal angiographic left to right shunt. 4 cases were failed. During a 3～36 months follow up, all patients remained cardiac functional class I. Color Doppler echocardiography showed no or minimal left to right shunt. No complication occurred except one case whose size of ventricular septal defect was larger as detected by left ventricular angiography. All patients discharged 2～4 days after the procedures. Conclusion The clinical application of catheter base to closure VSD is feasable in selective cases. Our prelimenary results suggest that the method is safe, less traumatic and free from surgical operations.