摘要
目的 总结Amplatzer封堵器 (ASO)封堵小儿房间隔缺损 (ASD)后出现并发症的种类及其防治方法。方法 应用Amplatzer封堵器封堵的 2 11例ASD患儿中 ,9例在术中或术后随访中出现并发症。其中体循环系统空气栓塞 2例、肺空气栓塞 1例、心包填塞 1例、封堵器脱落 1例、房性早搏1例、测量球囊碎片残留体内 1例、封堵器部分移位 1例、二尖瓣穿孔并返流 1例。分别给予内科、外科积极治疗及随诊观察等处理。结果 冠状动脉气栓及早搏病例自行缓解。封堵器部分移位及二尖瓣穿孔病例仍在随访观察中 ,其余病例均经治疗痊愈。结论 空气栓塞是应用ASO治疗时较易发生的并发症 ,且其发生多数与手术操作有关。并发症一旦发生大多需采取包括外科手术在内的积极处理。加强对ASO治疗病例的随访工作非常重要。
Objective To probe into the causes,therapeutic and preventive methods of complications associated with transcatheter occlusion of atrial septal defect using the Amplatzer septal occluder in children. Methods Complications occurred in 9 of 211 cases. The complications in procedure of occlusion were those in which there appeared systemic circulatory systemic air embolism in 2,pulmonary air embolism in 1,pericardial tamponade in 1,ASO malposition requiring emergency surgical removal in 1,transient atrial extrasystoles in 1 and sizing balloon rupture in 1 case. Two cases with postoperative complications were found in the follow-up studies. These included perforation of mitral valve and ASO partially dislodged. In this study,5 children with intra-procedure complication received emergency therapy including surgical intervention,and others were needed only in the follow-up,as the complications were transient or asymptomatic. Results There were no children′s deaths in this study. The 5 cases that received treatment completely healed,and the others with intra-procedure complications were also had no sequela. Cases with mitral valve perforation and ASO partially dislodged were still in our follow-up studies,as the 2 patients had no symptoms. Conclusion Air embolisms occurred easily in atrial septal defect cases that received ASO therapy. Complications were mainly caused by inappropriate operative procedure and some complications needed emergency treatments. Follow-up studies were important to cases with transcatheter occlusion therapy.
出处
《中国介入心脏病学杂志》
2003年第6期300-302,共3页
Chinese Journal of Interventional Cardiology
