单中心应用国产封堵器介入治疗中老年房间隔缺损的疗效及随访分析

Efficacy and follow-up analysis on the application of domestic occluder in atrial septal defect of elder patients in single interventional center

目的探讨国产封堵器治疗中老年房间隔缺损(atrial septum defect,ASD)的疗效及可能的并发症。方法回顾分析武警某部三甲医院心血管疾病介入治疗中心2002-09至2013-12应用国产封堵器治疗的97例中老年继发孔型ASD的临床资料。结果手术成功率为99.0%(96/97),置入封堵器直径14～44 mm[平均直径(26.8±6.9)mm]。围术期未出现严重并发症,平均2.3年随访(0.5～4年)中出现1例封堵器移位。封堵后及术后6～12个月行心脏超声检查发现患者的肺动脉压及右心负荷明显下降(P<0.05)。结论中老年ASD患者应用国产封堵器行介入治疗具有成功率、安全性高,以及恢复快等特点,可以有效地降低肺动脉压及右心负荷,已成为治疗ASD的首选方法。

Objective To study the efficacy and complications of the application of home-made atrial septum defect occluder for atrial septum defect （ASD） of elder patients in interventional operations. Methods Retrospectively analyzed 97 patients who aged more than 45 years of secundum atrial septal defect and were treated from Sep 2002 to Dec 2013 with home-made atrial septum defect occluderina cardiovascular interventional center of atop three hospital of armed police. Results The success rate of interventional operations with the application of home-made atrial septum defect oecluder was 99.0% （96/97）. The diameter of implanted occluder was between 14 mm and 44 mm, and the average diameter of oceluder was （26.8 ± 6.9） mm. There was no serious complications during perioperative period. The years of follow-up in the study was between 6 months and 4 years with an average follow-up of 2.3 years, and tracted 1 case of oceluder shift. Instant after closure operation and at 6 to 12 months of follow-up, the pulmonary artery pressure and the right heart overload decreased significantly by TI＇E （P〈0.05）. Conclusions Interventional treatment of elder patients of secundum atrial septal defect by home-made atrial septum defect occluder has become the preferred method, for its high technical success rate, high safety and quick recovery. It can reduce pulmonary artery pressure and decrease the right heart overload successfully.