经导管封堵主动脉窦瘤破裂

Transcatheter closure of ruptured aneurysm of valsalva sinus

目的探讨经导管封堵主动脉窦瘤破裂的临床疗效与安全性。方法用导管法对5例主动脉窦瘤破裂(3例右冠窦,2例无冠窦)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、心腔大小变化等进行回顾性分析研究。结果 5例患者均成功封堵,术后即刻心脏杂音消失,术后1个月时LVDD由术前(62.5±9.4)mm缩小为(47.5±4.3)mm。较术前明显缩小,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] Five patients admitted in our hospital, diagnosed as ruptured aneurysm of val- salva sinus drained into right atrium, and accepted transcatheter closure. During the regular one-month interval fol- low-up, echocardiography and ECG were performed. Cardiac murmur and size of each chamber before and after transcatheter closure were analyzed retrospectively. [ Results ] The procedures were successful in all patients. Car- diac murmur disappeared right after successful occlusion with domestic-madeoccluder. Left ventricular internal di- ameter decreased respectively from （62.5＋9.4） mm before transcatheter occlusion to （67.5_＋4.3） mm one month after occlusion. No complications occurred. [ Conclusion ] Transcatheter closure of RAVS is safe and effective, and can substitute surgical operation in some patients of RAVS.