经胸微创封堵治疗对先天性心脏病患者心脏重构的近期影响

Short-term effect of minimally invasive transthoracic closure on cardiac remodeling in patients with congenital heart disease

目的探讨经胸微创封堵治疗先天性心脏病术后近期心脏几何构型的变化。方法先天性心脏病患者31例,其中单纯性室间隔缺损(VSD)10例和房间隔缺损(ASD)21例,观察患者封堵术前、术后3个月左室内径(LVD)、左房内径(LAD)、右房内径(RAD)和右室内径(RVD)大小及左室射血分数(LVEF)变化。结果 31例患者中封堵成功29例(93.5%),其中单纯性VSD患者10例,单纯性ASD患者19例;失败2例(6.5%)均为单纯性ASD患者。封堵术后3个月,10例VSD患者LAD和LVD较术前明显缩小(P<0.05),RVD及LVEF明显增加(P<0.05);19例ASD患者RAD及RVD较术前明显减小(P<0.05),LVD及LVEF明显增加(P<0.05)。结论经胸微创封堵治疗ASD和VSD能有效地改善先天性心脏病患者近期心脏重构。

Objective To explore the short-term changes of cardiac geometric morphology after minimally invasive transthoracic closure of congenital heart disease.Methods Thirty-one patients with congenital heart disease were enrolled in this study,including 10 cases of ventricular septal defect （VSD） and 21 cases of atrial septal defect（ASD）.Left ventricular diameter（LVD）,left atrial diameter （LAD）,right atrial diameter（RAD）,right ventricular diameter（RVD） and left ventricular ejection fraction（LVEF） were measured before and three months after the closure.Results Of 31 cases,the closure was successfully completed in 29 cases（93.5%） including 10 cases of VSD and 19 cases of ASD,but was failed in 2 cases of ASD（6.5%）.Three months after the closure,for the 10 patients with VSD,LAD and LVD decreased significantly,while RVD and LVEF increased significantly compared with those before the closure（both P〈0.05）. For the 19 patients with ASD,RAD and RVD decreased significantly,while LVD and LVEF increased significantly compared with those before the closure（both P〈0.05）.Conclusion Minimally invasive transthoracic closure can effectively improve the short-term cardiac remodeling of patients with congenital heart disease.