BACKGROUND The off-label use of various devices has been reported for the transcatheter closure of perimembranous ventricular septal defects(PmVSD) because of serious complications, such as heart block and tricuspid r...BACKGROUND The off-label use of various devices has been reported for the transcatheter closure of perimembranous ventricular septal defects(PmVSD) because of serious complications, such as heart block and tricuspid regurgitation(TR),associated with conventional ventricular septal defect devices. However, whether certain defects such as PmVSD with abnormally attached tricuspid are fit for interventional treatment is still disputable.AIM To explore the feasibility and safety of transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae using an improved patent ductus arteriosus(PDA) occluder.METHODS We retrospectively analyzed 20 patients diagnosed with PmVSD with abnormally attached tricuspid chordae tendineae who underwent interventional treatment using an improved PDA occluder at our center from January 2012 to January 2016. Baseline characteristics and procedural and follow-up data were analyzed.RESULTS All 20 patients achieved procedure success. No heart block occurred during the operation. One patient had a transient complete right bundle branch block within48 h post-procedure and reverted to normal rhythm after intravenous injections of dexamethasone for 3 d. For all 20 patients, no residual shunt was observed by transthoracic echocardiography post-procedure. During the average follow-up period of 2.4 years, no severe TR was observed.CONCLUSION Using of the improved PDA occluder for the transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae is a safe and promising treatment option. However, long-term follow-up in a large group of patients is still warranted.展开更多
Purpose: The feasibility and validity of simultaneous transcatheter interventions for patients with atrial septal defect(ASD) complicated with patent ductus arteriosus(PDA) has not been systematically evaluated. Mater...Purpose: The feasibility and validity of simultaneous transcatheter interventions for patients with atrial septal defect(ASD) complicated with patent ductus arteriosus(PDA) has not been systematically evaluated. Materials and Methods: A retrospective analysis was conducted in patients who received transcatheter procedures for ASD complicated with PDA concurrently. The indications and treatment protocols were in accordance with the current guidelines. The sequence of therapy for ASD complicated with PDA was determined by clinical experience. Patients were followed up for at least 6 months after therapy Results: Overall, 22 patients received simultaneous transcatheter interventional therapy, and the success rate was a 100%. No severe complications transpired during the procedure or follow-up stage. Conclusion: Simultaneous transcatheter intervention is feasible and effective for patients who have concurrent complications for both ASD and PDA.展开更多
We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the l...We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the left pulmonary artery, the relationship between pulmonary artery and airway, the diameter of the patent ductus artery and atrial septal defect. The information is helpful in diagnosis, pre-operative evaluation and post-operative follow-up of LPS.展开更多
Objective: To evaluate the therapeutic effect, safety and complications oftranscathetering Amplatzer device in the closure of patent ductus arteriosus (PDA) and atrial septaldefects (ASD) in children. Methods: Patient...Objective: To evaluate the therapeutic effect, safety and complications oftranscathetering Amplatzer device in the closure of patent ductus arteriosus (PDA) and atrial septaldefects (ASD) in children. Methods: Patients with PDA (n = 25) and ASD ( n = 16), confirmed byechocardiography, were treated by transcatheterization. Amplatzer occluder device was placed by thetranscatheterization with the image support of X-ray and transthoracic echocardiography ( TTE) . TheTTE, ECG and X-ray examination were engaged to evaluate the therapeutic results on the time pointsof 24 h , 1, 3 , 6, 12 months after the operation, and all these cases were engaged to the follow-upexamination. Results: The cardioangiographic diameter was 13.0-28.0 mm ([19.3+-4.9] mm) in ASD and2.0-7.7 mm ([3.9+-1.5] mm) in PDA . The diameter of the Amplatzer occluder selected were 13.0-30.0mm ( [20.6+-5.1] mm) in ASD and 4.0-12.0 mm ([6.6+-1.9] mm) in PDA , respectively. All the Amplatzeroccluders were placed successfully. There were no complications during and after the operation.Very small residual shunt was still found soon after the operation in 10 cases , and there were noresidual or recanalization after three months of the operation. The pulmonary artery pressure andheart size were significantly decreased in follow-up examination . Conclusion: Transcatheteringclosure with Amplatzer device is an effective, simple and safe technique in the treatment of ASD andPDA in children.展开更多
目的平均肺动脉压(MPAP)是诊断和评价肺动脉高压的重要指标。本研究拟对比多普勒超声测量三尖瓣反流速度估测肺动脉收缩压(PASP)和三尖瓣反流速度诊断肺动脉高压2种方法,评价应用三尖瓣血流速度图对肺动脉高压的诊断效果。资料与方法收...目的平均肺动脉压(MPAP)是诊断和评价肺动脉高压的重要指标。本研究拟对比多普勒超声测量三尖瓣反流速度估测肺动脉收缩压(PASP)和三尖瓣反流速度诊断肺动脉高压2种方法,评价应用三尖瓣血流速度图对肺动脉高压的诊断效果。资料与方法收集2012年1月—2013年6月第四军医大学唐都医院以及沈阳军区总医院收治并拟行封堵术的先天性左向右分流心脏病患者80例。经心导管测量肺动脉压力,应用多普勒超声测量三尖瓣反流速度峰值。结果以导管测量的MPAP≥25 mm Hg为诊断标准,使用三尖瓣反流估算的PASP>30 mm Hg诊断肺动脉高压时,假阳性率为62.96%、假阴性率为0。使用三尖瓣反流速度诊断肺动脉高压具有较高的诊断一致性。分别以320 cm/s和340 cm/s为诊断界值时,假阳性率分别为14.81%和7.41%,假阴性率为15.91%和20.45%。结论对于左向右分流的先天性心脏病患者,采用超声心动图,并根据三尖瓣反流峰值速度直接诊断肺动脉高压可有效克服估算法存在较高假阳性率的问题,更适合基于MPAP为标准的肺动脉高压的诊断。展开更多
文摘BACKGROUND The off-label use of various devices has been reported for the transcatheter closure of perimembranous ventricular septal defects(PmVSD) because of serious complications, such as heart block and tricuspid regurgitation(TR),associated with conventional ventricular septal defect devices. However, whether certain defects such as PmVSD with abnormally attached tricuspid are fit for interventional treatment is still disputable.AIM To explore the feasibility and safety of transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae using an improved patent ductus arteriosus(PDA) occluder.METHODS We retrospectively analyzed 20 patients diagnosed with PmVSD with abnormally attached tricuspid chordae tendineae who underwent interventional treatment using an improved PDA occluder at our center from January 2012 to January 2016. Baseline characteristics and procedural and follow-up data were analyzed.RESULTS All 20 patients achieved procedure success. No heart block occurred during the operation. One patient had a transient complete right bundle branch block within48 h post-procedure and reverted to normal rhythm after intravenous injections of dexamethasone for 3 d. For all 20 patients, no residual shunt was observed by transthoracic echocardiography post-procedure. During the average follow-up period of 2.4 years, no severe TR was observed.CONCLUSION Using of the improved PDA occluder for the transcatheter closure of PmVSD with abnormally attached tricuspid chordae tendineae is a safe and promising treatment option. However, long-term follow-up in a large group of patients is still warranted.
文摘Purpose: The feasibility and validity of simultaneous transcatheter interventions for patients with atrial septal defect(ASD) complicated with patent ductus arteriosus(PDA) has not been systematically evaluated. Materials and Methods: A retrospective analysis was conducted in patients who received transcatheter procedures for ASD complicated with PDA concurrently. The indications and treatment protocols were in accordance with the current guidelines. The sequence of therapy for ASD complicated with PDA was determined by clinical experience. Patients were followed up for at least 6 months after therapy Results: Overall, 22 patients received simultaneous transcatheter interventional therapy, and the success rate was a 100%. No severe complications transpired during the procedure or follow-up stage. Conclusion: Simultaneous transcatheter intervention is feasible and effective for patients who have concurrent complications for both ASD and PDA.
文摘We report a case of left pulmonary artery sling associated with patent ductus arteriosus and atrial septal defect in a 21-month-old child. 256-slice MDCT provides valuable information, such as abnormal origin of the left pulmonary artery, the relationship between pulmonary artery and airway, the diameter of the patent ductus artery and atrial septal defect. The information is helpful in diagnosis, pre-operative evaluation and post-operative follow-up of LPS.
文摘Objective: To evaluate the therapeutic effect, safety and complications oftranscathetering Amplatzer device in the closure of patent ductus arteriosus (PDA) and atrial septaldefects (ASD) in children. Methods: Patients with PDA (n = 25) and ASD ( n = 16), confirmed byechocardiography, were treated by transcatheterization. Amplatzer occluder device was placed by thetranscatheterization with the image support of X-ray and transthoracic echocardiography ( TTE) . TheTTE, ECG and X-ray examination were engaged to evaluate the therapeutic results on the time pointsof 24 h , 1, 3 , 6, 12 months after the operation, and all these cases were engaged to the follow-upexamination. Results: The cardioangiographic diameter was 13.0-28.0 mm ([19.3+-4.9] mm) in ASD and2.0-7.7 mm ([3.9+-1.5] mm) in PDA . The diameter of the Amplatzer occluder selected were 13.0-30.0mm ( [20.6+-5.1] mm) in ASD and 4.0-12.0 mm ([6.6+-1.9] mm) in PDA , respectively. All the Amplatzeroccluders were placed successfully. There were no complications during and after the operation.Very small residual shunt was still found soon after the operation in 10 cases , and there were noresidual or recanalization after three months of the operation. The pulmonary artery pressure andheart size were significantly decreased in follow-up examination . Conclusion: Transcatheteringclosure with Amplatzer device is an effective, simple and safe technique in the treatment of ASD andPDA in children.
文摘目的平均肺动脉压(MPAP)是诊断和评价肺动脉高压的重要指标。本研究拟对比多普勒超声测量三尖瓣反流速度估测肺动脉收缩压(PASP)和三尖瓣反流速度诊断肺动脉高压2种方法,评价应用三尖瓣血流速度图对肺动脉高压的诊断效果。资料与方法收集2012年1月—2013年6月第四军医大学唐都医院以及沈阳军区总医院收治并拟行封堵术的先天性左向右分流心脏病患者80例。经心导管测量肺动脉压力,应用多普勒超声测量三尖瓣反流速度峰值。结果以导管测量的MPAP≥25 mm Hg为诊断标准,使用三尖瓣反流估算的PASP>30 mm Hg诊断肺动脉高压时,假阳性率为62.96%、假阴性率为0。使用三尖瓣反流速度诊断肺动脉高压具有较高的诊断一致性。分别以320 cm/s和340 cm/s为诊断界值时,假阳性率分别为14.81%和7.41%,假阴性率为15.91%和20.45%。结论对于左向右分流的先天性心脏病患者,采用超声心动图,并根据三尖瓣反流峰值速度直接诊断肺动脉高压可有效克服估算法存在较高假阳性率的问题,更适合基于MPAP为标准的肺动脉高压的诊断。
