合并三尖瓣中重度反流的膜周部室间隔缺损介入封堵疗效评价

Evaluation of therapeutic effect of interventional occlusion for perimembranous ventricular septal defect with moderate to severe tricuspid regurgitation

目的观察合并三尖瓣中重度反流的膜周部室间隔缺损行介入封堵的疗效及远期预后。方法通过超声心动图选取合并中重度三尖瓣反流的膜周部室间隔缺损患者53例,均无三尖瓣器质性病变,观察行介入封堵后室间隔缺损的封堵效果及三尖瓣反流程度的变化情况。结果所有室间隔缺损患者均封堵成功,52例三尖瓣反流面积、速度、压差均较随介入时间的推移呈现减小或下降趋势(P<0.05);1例患者术后出现封堵器与三尖瓣腱索缠绕、三尖瓣重度反流,后行室间隔缺损修补术及三尖瓣成形术,术后恢复良好。结论术前严格筛查,部分合并三尖瓣中重度反流的膜周部室间隔缺损患者行介入封堵安全有效。

Objective To observe the therapeutic effect and long-term prognosis of interventional occlusion for perimembranous ventricular septal defect(PMVSD)with moderate to severe tricuspid regurgitation.Methods Fifty-three patients with PMVSD complicated by moderate to severe tricuspid regurgitation were selected by echocardiography,and none of them had organic tricuspid valve disease.The therapeutic effect of interventional occlusion for PMVSD and the changes of tricuspid regurgitation were observed.Results PMVSD of all patients was successfully occluded.The area,velocity and pressure difference of tricuspid regurgitation in 52 patients were reduced or decreased with the time of intervention(P<0.05).One patient had severe tricuspid regurgitation because of occluder intertwined with tendinous cord of tricuspid valve after intervention,and underwent ventricular septal defect repair and tricuspid valvuloplasty.He recovered well after operation.Conclusion After strict preoperative screening,interventional occlusion is safe and effective for some PMVSD patients with moderate to severe tricuspid regurgitation.