膜部室间隔缺损介入治疗的临床探讨

Clinical discuss of interventional therapy for membranous ventricular septal defect

目的:探讨膜部室间隔缺损介入治疗的方法,评价国产封堵器治疗膜部室间隔缺损的临床疗效和安全性。方法:对22例成人先天性心脏病膜部室间隔缺损病例经国产膜部室间隔封堵器行封堵介入治疗,术前所有病例经胸超声心动图初筛选,左室造影最终筛选确定。男性13例,女性9例,年龄18～36岁,平均30岁,术中所有病例均使用经胸超声心动图监测。随访3个月～1年,胸超声心动图、X线观察疗效和安全性。结果:22例封堵手术成功,即刻手术成功率100%,无残余分流,无主动脉瓣反流、房室瓣反流,未发生感染性心内膜炎,术后患者胸闷、心悸症状消失,心电图随访无房室传导阻滞也无束支传导阻滞并发症,封堵伞位置良好。结论:国产封堵器封堵介入治疗成人膜部室间隔缺损是有效、安全的。

Objective:To discuss the method of interventional therapy for membranous ventricular septal defect and evaluate the clinical effect and safety of domestic occluder for transcatheter membranous ventricular septal defects(VSD)occlusion.Methods:22 cases of adult congenital heart disease were treated through interventional therapy using domestic occluder for transcatheter membranous ventricular septal defects occlusion.All cases were preliminary screened by transthoracic echocardiography before operation and final determined by left ventriculography. Of 22 patients,there were 13 males and 9 females,with a median age of 30 years(rang from 18 to 36).All cases were measured by transtho-racic echocardiography during operation and followed up for three months to one year.The clinical effect and safety were observed by transthoracic echocardiography and X rays.Results:22 cases of interventional occlusion were successful,the success rate was 100%.There was no residual shunts,no aortic regurgitation and atrioventricular valve regurgitation.No infective endocarditis happened.The patients' symptoms of chest distress and palpitaion dispeared;no complications of atrioventricular block and bundle branch block occurred during follow-up by electrocardiogram. The position of occlusion umbrella was good.Conclusion: Interventional therapy for adult membranous ventricular septal defect using domestic occluder device is safe and effective.