偏心型封堵器经皮介入封堵室间隔缺损与外科对比研究

Contrastive research of ventricular septal defect treatment: interventional occlusion using asymmetric occluders and surgical procedures

目的比较偏心型封堵器与传统外科手术治疗干下型室间隔缺损（VSD）的疗效及并发症情况。方法回顾性分析2005年3月至2012年3月在武汉亚洲心脏病医院治疗的干下型VSD病例102例,其中使用偏心型封堵器经皮介入封堵治疗52例（介入组）,同期行外科开胸手术50例（外科组）。比较两组患者术后的疗效、并发症及预后情况。结果介入组52例患者中40例（76.9%）手术成功,发生并发症12例（23.1%）。外科组50例中成功47例（94.0%）,发生并发症3例（6.0%）。随访2~12个月,两组患者均未见死亡病例。结论与传统外科手术相比,偏心型封堵器治疗干下型VSD,成功率低、并发症发生率高,需慎重选择治疗方案。

Objective To compare the feasibility and effectiveness of interventional subarterial ventricular septal defect（ VSD） occlusion using asymmetric occluders and traditional surgical treatment.Methods A retrospective analysis was made in 102 patients with subarterial ventricular septal defect in March 2005 to March 2012 in Wuhan Asia Heart Hospital. 52 patients underwent percutaneous intertional occlusion using asymmetric occluders（ intervention group） and 50 patients with surgical treatments at the same time（ surgery group）. The outcome,complication and prognosis of the two groups were compared.Results Among the 52 patients in the intervention group,12 procedures failed due to complications（ 23. 1%）. The intervention success rate was 76. 9%. In the surgical group,3 patients presented complications（ 6. 0%） and the operation success rate was 94. 0%. No recorded montality in both groups during follow up of 2-12 months. Conclusions Compared with traditional surgery,interventional occlusion using asymmetric occluders in subarterial ventricular septal defect has lower success rates, higher complication rate. This implies more careful treatment plan is needed for these group of patients.