经导管治疗室间隔缺损

Transcatheter occlusion of ventricular septal defects

目的 评价经导管治疗室间隔缺损 ( VSD)的疗效及其安全性。 方法 17例 VSD患者经胸超声心动图显示 ,膜部 VSD 16例 ,肌部 VSD 1例 ;合并室间隔瘤 1例 ;2例 VSD上缘距离主动脉瓣 1mm,其余均在 1mm以上 ;VSD直径 2 .3～ 10 mm( 5 .0 5± 2 .0 3mm)。所有患者均无严重的肺动脉高压或右向左分流。膜部 VSD封堵使用Amplatzer膜部室间隔封堵器和国产室间隔封堵器 ,肌部 VSD使用 Amplatzer动脉导管封堵器。 结果 17例 VSD造影测量值为 2 .3～ 10 .5 mm( 5 .75± 2 .10 mm) ,选择的封堵器直径为 4～ 12 mm( 7.12± 1.6 7mm)。 17例患者均成功行 VSD封堵术 ,封堵后 10分钟造影无残余分流。 1例术后即刻出现 I度房室传导阻滞伴右束支传导阻滞 ,无症状 ;2例术后 3～ 4天出现右束支传导阻滞 ,全部患者均随访 1～ 12个月 ,无其它并发症和残余分流发生。 结论 经导管治疗

Objective To access the feasibility, effectiveness and safety of transcatheter closure of ventricular septal defects(VSD) in 17patients. Methods Seventeen patients, aged 4 23 years, were selected by transthoracic echocardiography. The location of VSD was perimembranous in 16 patients and was muscular in 1 patient. And 1 patient with aneurysm formation. All cases had no severe pulmonary hypertension or right to left shunt. Membranous VSD underwent transcatheter closure with Amplatzer membranous VSD occluder or membranous VSD occluder made in China. Muscular VSD was closed by Amplatzer patent ductus arteriosus occluder. Results The VSD diameter ranged from 2.3 10.5 mm(5.75±2.10 mm). The device diameter ranged from 4 12 mm (7.12±1.67 mm). After application of the prosthesis there was no residual shunt in all patients. One patient developed grade I atrioventricular block and complete right bundle branch block. Two patients developed right bundle branch block after 3 4 days. No other complications were observed in 1 12 months follow up. Conclusion The transcatheter closure of VSD appears to be a safe and effective method.