国产封堵器治疗室间隔缺损的临床疗效

Clinical effect of ventricular septal defect treated with domestic occluder

目的探讨国产封堵器介入治疗室间隔缺损(ventricular septal defect,VSD)的临床疗效。方法应用国产封堵器对2014年12月至2017年12月于本院就诊的148例VSD患者行经皮导管封堵手术。结果成功封堵146例(98.6%)。应用对称型室间隔封堵器直径为4～16 mm,偏心型室间隔封堵器直径为6～10 mm,小腰大边型封堵器直径为4～6 mm,另外2例采用动脉导管未闭Amplatzer伞封堵。术后出现并发症有:影响瓣膜启闭1例,封堵器脱落2例,心律失常19例(左束支阻滞8例,间歇性左右束支阻滞1例,完全性右束支阻滞2例,左前分支阻滞2例,室性加速性逸搏心律6例),机械性溶血9例。结论国产封堵器治疗VSD有效、安全,是一项值得推广的微创治疗方法。

Objective To explore the clinical efficacy of transcatheter closure of ventricular septal defect （VSD） using domestic occluders. Methods Between December 2014 and December 2017, a total of 148 patients, who were confirmed VSD in the hospital,underwent transcatheter closure with domestic occluders.Results Occlusion succeeded in 146 cases （98. 6%） using symmetric VSD occluder（range, 4 to 16 mm）,eccentric VSD occluder （range, 6 to 10 mm） and small-waist and large-disc one （range, 4 to 6 mm）, and 2 cases of patent ductus arteriosus （PDA）used Amplatzer duct occluder. Thirty-one adverse events were reported including 1 case of recurrence of aortic valves, 2 cases of occluder falling-off and 19 cases of arrhythmia （8 cases of left bundle branch block, 1 case of intermittent left and right bundle branch block, 2 cases of complete right bundle branch block, 2 cases of left anterior branch block and 6 cases of ventricular accelerated escape rhythm）, as well as 9 cases of mechanical hemolysis. Conclusion Transcather closure of VSD with domestic shape occluder is a reliable and safe micro-invasive treatment, which is worth promoting.