改良输送鞘通过法行房间隔缺损封堵术100例临床分析

Clinical analysis of modified transcatheter closure of atrial septal defect in 100 cases

目的：分析使用改良输送鞘通过法行房间隔缺损介入封堵术治疗继发孔型房间隔缺损的临床效果。方法回顾性分析2012年12月至2013年12月，在北京安贞医院以改良输送鞘通过法行房间隔介入封堵术完成的100例继发孔型房间隔缺损患者，其中女72例，平均年龄3～76（37±16）岁。全部患者经胸超声心动图完成诊断及对缺损大小进行测量，并使用改良输送鞘通过法行房间隔缺损封堵术，该术式输送鞘无需加硬导丝导引而直接经过缺损送入左心房。结果经胸超声心动图证实100例患者共存在101处缺损，其中有1例患者有2处缺损。测得缺损平均最大径为（20.3±6.7）mm，共植入4个品牌的100枚封堵器，封堵器平均尺寸为（28.1±7.5）mm。封堵器均通过改良输送鞘通过法植入成功，经胸超声心电图证实100例患者房水平分流消失。术中1例患者出现心房颤动（房颤），术后房颤消失。随访时间为1～12个月，随访期间无严重并发症发生。结论使用改良输送鞘通过法实施房间隔缺损介入封堵术并发症发生率低，近中期疗效肯定。

Objective To summraize the safety and efifcacy of modiifed transcatheter closure of atrial septal defect. Methods From Dec. 2012 to Dec. 2013, 100 cases performed modiifed transcatheter closure of atrial septal defect in our center （72 were famale and 28 were male） with average age （37±16） years. The diagnosis was conifrmed by transthoracic echocardiography. All the atrial septal defect closures were completed in the modiifed way by direct delivery of the closure devices without the need of guidence wire. Results One hundred and one defects were identiifed in 100 patients, with 1 patient had 2 defects. The mean diameter of the defect was （20.3±6.6） mm. 100 devices were implanted successfully. Complete closure was revealed in all the patients after the procedure. One patient developed atrial ifbrillation during the procedure. No other serious complication occurred till the last follow-up. Conclusions The modiifed transcatheter closure of atrial septal defect is an effective procedure with high successful rate and low rate of complications.