微创房间隔缺损封堵术8例临床研究

Clinical Research of Microinvasive Operation to Close Ostium Secundum in Atrial Septal Defects

目的:总结微创房间隔缺损封堵术治疗先天性心脏病继发孔型房间隔缺损的初步经验。方法:全组8例,年龄6～59岁,手术前经食管超声心动图(TEE)检查先天性心脏病房间隔缺损(ASD)直径平均为17～35mm。所有病例均在TEE指引下经输送器置入封堵伞。1例ASD为双孔型,置入2个封堵伞。术后分别采用经胸超声心动图(TTE)、心电图、X线评价治疗效果。结果:8例手术均获得成功,术中未发生任何并发症。经4～7个月随访,TTE示无残余漏发生。X线检查全部显示肺血减少,右心房、室缩小。结论:微创房间隔缺损封堵术治疗ASD具有安全、高效、微创的优点,适合各年龄组继发孔型ASD。其临床应用的中远期疗效和手术适应证有待继续观察。

Objective:To summarize the experience of microinvasive operation to close ostium secundum in atrial septal defects(ASD).Methods:Eight patients with ASD were treated by microinvasive method to close ASD with special occluder device. The mean age of patients was 23.1 years(ranging from 6-59 years).The mean diameter of ASD was 24mm (ranging from 17 to 35mm).All the cases were treated with special occluder device under the guidance of transesophageal echocardiography(TEE).One case had double ASD.The efficiency after the procedure was evaluated by TTE,ECG and X ray examination.Results:The success rate of placement of special occluder device was 100%.No complications happened during the procedure. After 4 to 7 months tracing, no residual shunt was found by TTE.The pulmonary vascularity and heart size in X ray examination.were improved Conclusion:The microinvasive operation to close ostium secundum in ASD is safe, efficient and suitable for any age patients.The long term follow up remains to be studied.