介入封堵治疗右位心合并单纯房、室间隔缺损临床疗效分析

Clinical analysis of transcatheter closure of simple atrial and ventricular septal defect in patients associated with dextrocardia

目的探讨右位心合并单纯房间隔缺损(ASD)及室间隔缺损(VSD)患者行介入封堵治疗的可行性。方法回顾性分析自2013年6月至2017年1月沈阳军区总医院收治6例确诊为右位心合并ASD或VSD患者的临床资料,行介入封堵治疗,观察临床治疗效果。结果所有6例患者均成功接受介入封堵治疗。封堵术后,经胸超声心动图示房间隔未见残余分流;重复左心室造影,均未见明显残余分流。心脏X线检查、心电图及超声心动图均未见明显异常。围术期及术后随访期间均未出现恶性心律失常、心包积液、封堵器脱落等严重并发症。结论右位心合并单纯性ASD或VSD,行介入封堵虽有其特殊性,但如果熟悉右位心解剖结构,仍为一种安全、有效的方法。

Objective To investigate the feasibility of interventional occlusion for patients with atrial septal defect（ ASD） or ventricular septal defect（ VSD） and dextrocardia. Methods A retrospective study was performed on 6 cases of patients with ASD or VSD and dextrocardia who were admitted from June 2013 to January 2017. Patients were performed interventional occlusion and the clinical effect was observed. Results All patients were successfully performed interventional occlusion. No residual shunt in the atrial septum was found by TTE. Left ventriculography was repeated after occlusion,and no significant residual shunt was found. No obvious abnormalities were found in the examination of cardiac X-ray,electrocardiogram and TTE. There were no serious complications such as malignant arrhythmia,pericardial effusion or occluder abscission found during the perioperative period and follow-up period.Conclusion There are some special characteristics of patients with dextrocardia,if we are familiar with the anatomical structure of the dextrocardia,transcatheter closure of ASD or VSD is still a safe and effective method.