应用Amplatzer封堵器经皮穿刺治疗房间隔缺损及动脉导管未闭

Percutaneous Closure of Atrial Septal Defect and Patent Ductus Arteriosus with Amplatzer Occluder Device

目的 :探讨应用Amplatzer封堵器治疗二孔型房间隔缺损 (ASD)及动脉导管未闭 (PDA)的效果。方法 :术前均常规经胸超声心动图 (TTE)确认ASD或PDA位置、大小及形态 ,分流情况及肺动脉压。在透视监视下经导管置入封堵器。成人ASD术中在经食道超声 (TEE)监视下了解ASD的诸边缘及封堵结果。儿童使用经胸超声监视。PDA封堵前后分别行主动脉造影 ,确认PDA形态、大小及封堵结果。术后1个月及6个月分别经TTE评价治疗结果。结果 :全组8例均手术成功 ,无任何并发症。术后24hTTE显示全部病例封堵成功 ,无残余分流。随访2～26个月 ,全部病例无再通 ,肺动脉压正常 ,增大的心脏房室恢复正常。结论 :经皮穿刺应用Amplatzer封堵器治疗二孔型ASD及PDA疗效肯定 ,操作简便 ,成功率高 。

Objective:To report the experence of transcatheter closure of secundum atrial septal defect(ASD)and patent ductus arteriosus(PDA)using Amplatzer occluder device.Methods:There were8patients with4ASD and4PDA.The age ranged from8to64years old with a mean of(31.6±16.5)years.Transthoracic echocardiograms(TTE)were performed in all patients preoperatively.The status of ASD and PDA included the diameter and site of defect and pulmonary pressure.Each case was occluded using Amplatzer occluder device through the percutaneous procedure.The closure procedure was guided by fluoroscopy.In ASD case,the procedure was monitored by transesophageal echocardiography(TEE),and was monitored by TTE in child case.Aorta angiography was carried out in PDA case before and after PDA be closured.All patients were evaluated using TTE1and6months after operation.Results:The successful rate of operation was100%.The residual shunt would not be found in total case24hours postoperatively.Conclusion:Transcatheter closure of ASD and PDA using Amplater occluder device is an effective interventional method with a high successful rate of operation and simple procedure.