儿童房间隔缺损经皮介入封堵相关并发症防治进展

Advances in prevention and treatment of complications related to percutaneous intervention of atrial septal defect in children

房间隔缺损(atrial septal defect,ASD)是儿童较常见的先天性心脏病之一。大多数患儿无明显临床表现,但随着年龄的增长,持续性左向右分流会使右心负荷增加,从而影响心功能。因此,早期采取干预措施对这些患儿至关重要。经皮介入封堵术现已取代传统外科手术成为儿童ASD的主要治疗方式,术后并发症发生率虽低但危害较大。严重并发症包括封堵器移位或脱落、心脏磨蚀、房室传导阻滞、血栓形成及血栓栓塞、空气栓塞和溶血。常见并发症包括头痛或偏头痛、残余分流、血管相关并发症。该文就儿童ASD介入封堵相关并发症的发病机制、临床表现及其防治措施进行综述。

Atrial septal defect(ASD)is one of the most common congenital heart diseases in children.Although most children with this condition may not exhibit clinical symptoms,persistent left-to-right shunting can increase the burden on the right heart and compromise cardiac function as they age.Therefore,early intervention is crucial for these children.Percutaneous intervention has superseded conventional surgery as the primary mode of treatment for secondary atrial septal defect in children.The procedure has a low rate of postoperative complications,but carries a substantial risk.Serious complications include unsatisfactory device position or embolization,cardiac erosion,atrioventricular block,thrombosis or thromboembolism,air embolism,and hemolysis.Common complications include headache or migraine,residual shunt,and vascular-related complications.This review focuses on the pathogenesis,clinical presentations,prevention and treatment of complications related to percutaneous intervention of atrial septal defect in children.