摘要
关于使用Amplatzer膜周部室间隔缺损(PMVSD)封堵器经导管封闭PMVSD初期结果令人鼓舞的报道很少。本文中报道了在5家不同机构接受Amplatzer PMVSD封堵器经导管封闭缺损的54例PMVSD患者的初期和1年结局。在5个欧洲中心纳入65例PMVSD患者,其中有11例在初期超声心动图评估或在心导管术时未达到患者入选标准。
There are very few published reports of the transcatheter closure of perimembranous ventricular septal defects(PMVSDs) using the Amplatzer PMVSD occluder with encouraging initial results. This report presents initial and 1-year results from 54 patients with PMVSDs who underwent transcatheter closure at 5 different institutions with the Amplatzer PMVSD occluder. Sixty-five patients with PMVSDs were enrolled at 5 European centers. Eleven of the 65 patients did not fulfill the patient selection criteria at the initial echocardiographic evaluation or at cardiac catheterization. As a result, a total of 54 patients underwent attempted transcatheter closure using the Amplatzer PMVSD occluder. The median age of the patients was 5.1± 3.6 years(range 0.3 to 13), and the median weight 18.5± 10.3 kg(range 5 to 45). Devices were permanently implanted in 49 of 54 patients. Complete occlusion of the communication at 1-year follow-up was observed in 46 of 49 patients(94% ). Main early procedural complications included(1) device embolization(2 patients),(2) severe bradycardia with hemodynamic compromise(2 patients), and(3) Mobitz II(2∶ 1) heart block(1 patient). Late procedural complications included complete heart block(1 patient). No other complications were observed during follow-up. In conclusion, the Amplatzer PMVSD occluder is promising device that can be used for transcatheter closure in selected patients with PMVSDs. Further studies and long-term follow-up are required before this technique enters routine clinical practice.
