介入封堵治疗儿童室间隔缺损并主动脉瓣脱垂疗效分析

Interventional occlusion for ventricular septal defect and aortic valve prolapse in children

目的探讨不同类型室间隔缺损（ventricularseptaldefect，VSD）并主动脉瓣脱垂（aorticvalveprolapse，AVP）介入治疗的个体化治疗方案。方法28例VSD并AVP患儿行经皮封堵术，经胸超声心动图及左心室造影进行诊断及分类。结果15例为膜周流出道型，7例为隔瓣后型，6例为膜周部型；患者均伴有局限AVP；VSD直径2．5～9．2mm，20例缺损口上缘距主动脉瓣〈2mm；介入治疗成功率89．3％（25／28）；未出现三尖瓣、主动脉瓣狭窄及主动脉瓣穿孔，无Ⅲ度房窀传导阻滞等严重心律失常发生。结论介入治疗不同类型VSD并AVP安全、有效。

Objective To explore the individual interventional occlusion plan for different types of ventricular septal defect （VSD） and aortic valve prolapse （AVP）. Methods Twenty-eight patients with VSD and AVP receiving interventional occlusion were diagnosed and classified according to the results of transthoracic echocardiography and the left ventricular angiography. Results In these 28 cases, VSD occurred in perimenbranous outflow tract in 15 cases, in inflow tract in 7 cases and in perimembranous in 6 cases. And all were complicated with partial AVP. The diameters of VSI） were from 2.5 to 9.2 mm and the distance from the upper edge of VSD to the aortic valve was 〈2 mm in 20 cases. ＂The total successful rate was 89. 3% （25/28）. No tricuspid and aortic valve stenosis or aortic valve perforation was observed. No complete atrial ventrieular block or other severe arrhythmia occurred. Conclusion It is safe and feasible to perform interventional occlusion for different types of VSD and AVP.