先天性心脏病介入治疗严重并发症发生原因及应对策略

Cause Analysis and Countermeasures of Severe Complications of Congenital Heart Defect after Unsuccessful Interventional Treatment

目的分析先天性心脏病介入治疗严重并发症发生的原因,并提出应对策略。方法回顾性分析2000年1月—2015年12月,沈阳军区总医院先天性心脏病介入治疗后出现严重并发症22例的临床资料。结果本组介入治疗后发生房间隔缺损(atrial septal defect,ASD)15例,室间隔缺损(ventricular septal defects,VSD)6例,动脉导管未闭(patent ductus arteriosus,PDA)1例,均采用全麻体外循环下心脏直视手术,取出封堵器、矫治心内畸形,外科手术开放升主动脉后全部自动复跳,术后恢复良好。结论术前明确诊断及严格掌握介入手术适应证是防止术后严重并发症发生的关键;术后应及时采取应对策略最大限度避免病情恶化,并矫治心脏畸形,有效控制并发症发生。

Objective To analyze the causes of severe complications of congenital heart defect after unsuccessful interventional treatment and propose appropriate reasonable countermeasures. Methods A total of 22 patients with severe complications following unsuccessful interventional treatment for congenital heart defect during January 2000 to December 2015 were included in this retrospective analysis. Results There were 15 cases of atrial septal defect （ASD） , 6 cases of ventricular septal defect （VSD） and 1 case of patent duct closure （PDA） after interventional therapy, and all the patients underwent occluder removal successfully and defect correction with satisfactory outcome. All the cases underwent cardiac resuscitation automatically and detached from cardiopulmonary bypass （CPB） successfully under general anesthesia. Conclusion Preoperative diagnosis and strict indications of interventional procedures are key to preventing serious complications after interventional therapy; the strategy should be taken in time to full extent to prevent the deterioration of the disease, to correct cardiac malformations and to effectively control complications after treatment failure.