经股动脉应用第二代Amplatzer ADOⅡ进行儿童室间隔缺损介入封堵治疗的疗效研究

Application of Amplatzer duct occluder Ⅱ in interventional treatment of children ventricular septal defect

目的探讨第二代Amplatzer动脉导管未闭封堵器(ADOⅡ)进行儿童室间隔缺损(ventricular septal defect,VSD)介入封堵治疗的的疗效及安全性.方法回顾性分析2017年3月至2018年3月在武汉亚洲心脏病医院接受介入治疗的VSD病例180例,其中使用ADOⅡ封堵器治疗85例(ADOⅡ组),使用常规对称性VSD封堵器治疗95例(常规组).比较两组患者术后的疗效、并发症及预后情况.结果ADOⅡ组85例患者中83例(97.65%)手术成功,失败2例(2.35%).常规封堵器组95例中成功86例(90.53%),失败9例(9.47%).随访1年,两组均未见死亡、心包压塞、感染性心内膜炎、心肌梗死及封堵器脱落病例.结论与常规对称性封堵器相比,ADOⅡ封堵器治疗VSD成功率高,术后封堵效果好,手术相关并发症发生率低,可作为VSD介入治疗常规器械之一.

Objective To investigate the efficacy and safety of closing children ventricular septal defect(VSD)using the Amplatzer duct occluder Ⅱ(ADO Ⅱ).Methods A retrospective analysis was made in 180 patients with ventricular septal defect in March 2017 to March 2018 in Wuhan Asia Heart Hospital.85 patients underwent percutaneous intertional occlusion with ADO Ⅱ(ADO Ⅱ group)and 95 patients with conventional VSD occluders(conventional group).The outcome,complication and prognosis of the two groups were compared.Results Among the 85 patients in the ADO D group,2 case was failed(2.35%).The success rate of ADO Ⅱ group was 97.65%.In the conventional group,9 case was failed(9.47%)and the success rate was 90.53%.There were no death,cardiac tamponade,infective endocarditis,myocardial infarction and occluder abscission in both groups during follow up of 12 months.Conclusion Compared with conventional VSD occluders,interventional occlusion using ADO Ⅱ in ventrieular septal defect has a higher success rate and lower complication rate.ADO Ⅱ is a good alternative selection for VSD interventional therapy.