房间隔缺损封堵术致病态窦房结综合征样改变1例

A case report of sick sinus syndrome induced by atrial septal defect closure

房间隔缺损(ASD)封堵术是治疗继发孔型ASD有效手段,可以逆转ASD导致的血流动力学异常。心律失常是ASD封堵术常见并发症之一,但发生病态窦房结综合征样改变却少有报道,其表现主要以窦性心动过缓、窦房传导阻滞、窦性停搏为主,也可出现心动过缓-心动过速综合征。严重者可出现与心动过缓有关的心、脑等脏器供血不足的症状,如发作性头晕、黑朦,甚至晕厥,需接受起搏器治疗。本病例报道1例20岁女性患者ASD封堵术后出现少见的病态窦房结综合征样改变严重并发症,经积极对症处理,病情稳定出院。门诊多次随访至今恢复良好,可为今后临床处理类似病例提供参考。针对此类ASD较大的患者,术前需要做好充分评估,术中选择大小合适的封堵器,术后加强监测,长期随访。

Atrial septal defect(ASD)closure is the effective means of treating the second-hole ASD,which can reverse the blood flow dynamic abnormalities caused by ASD.Arrhythmia is one of the common complications of ASD blocking techniques,but the changes in pathogenic sinus node syndrome in the occurrence of disease-state sinus node syndrome are rarely reported.There can also be heartbeat-tachycardia syndrome.This case reports a 20-year-old female patient who developed rare pathological sinus syndrome like changes and severe complications after ASD occlusion surgery.Good recovery can provide reference for similar cases in clinical treatment in the future.In response to patients with a large number of room septal defects,they need to be fully evaluated before surgery.Select a suitable seal-blocking device during the operation,strengthen monitoring after surgery,and follow up for a long time.