经静脉闭合房间隔缺损的疗效观察

Transcatheter occlusion of secundum atrial septal defect with the Amplatzer septal occluder

目的 :评价经静脉置入 Amplatzer封堵器治疗继发孔型房间隔缺损 (ASD)的疗效。方法 :2 4例患者术前经多普勒超声心动图检查 ASD直径为 6～ 30 (18.96± 7.0 3) m m。在透视及经超声心动图引导下经静脉置入Am platzer封堵器闭合 ASD。结果 :2 4例 ASD直径的球囊测量值为 15～ 36 (2 6 .2 5± 7.5 7) mm ,选择的封堵器直径为 14～ 36 (2 6 .5 2± 7.15 ) m m。 2 4例封堵器置入均获得成功 ,术中无并发症 ,1例在术后第 3天出现 度 型房室传导阻滞 ,2周后恢复。 7例术后即刻超声检查显示微量残余分流 ,术后 1周复查均无分流。结论 :经静脉置入 Amplatzer封堵器治疗 ASD是一种有效的非外科手术方法。

Objective:To evaluate the efficiency of transvenous oclusion of secundum atrial septal defect (ASD) using Amplatzer occluder.Method:There were 24 patients ( 6 male and 18 female, mean age 26.6 years). Echocardiography confirmed the ASD with a diameter of ( 18.96 ± 7.03 )mm (ranging from 6 to 30 mm). All patients with ASD were treated using Amplatzer occluder under guiding fluoroscopy and echocardiography through the percutaneous procedure.Result:The mean balloon stretched diameter of the ASDs in 24 patients was 15~36( 26.25 ± 7.57 )mm.The mean diameter of the occluder selected was 14~36( 26.52 ± 7.15 )mm.The successful rate of placement of the Amplatzer occluder was 100%. No complication was found during the procedures and during follow up. Trivial residual shunt was found in 7 patients immediately after the procedures, and there was no residual shunt 1 week after the procedures and during follow up.Conclusion:Transvenous closure of secundum ASD using Amplatzer septal occluder is an efficient nonsurgical method.