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Congenital heart“Challenges”in Down syndrome
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作者 Maria Drakopoulou Panayotis K Vlachakis +1 位作者 Costas Tsioufis Dimitris Tousoulis 《World Journal of Cardiology》 2024年第5期217-220,共4页
In this editorial,we comment on the article by Kong et al published in the recent issue of the World Journal of Cardiology.In this interesting case,the authors present the challenges faced in managing a 13-year-old pa... In this editorial,we comment on the article by Kong et al published in the recent issue of the World Journal of Cardiology.In this interesting case,the authors present the challenges faced in managing a 13-year-old patient with Down syndrome(DS)and congenital heart disease(CHD)associated with pulmonary arterial hypertension.In this distinct population,the Authors underscore the need for early diagnosis and management as well as the need of a multidisciplinary approach for decision making.It seems that the occurrence of CHD in patients with DS adds layers of complexity to their clinical management.This editorial aims to provide a comprehensive overview of the intricate interplay between DS and congenital heart disorders,offering insights into the nuanced diagnostic and therapeutic considerations for physicians. 展开更多
关键词 Down syndrome congenital heart disease Atrioventricular septal defect Pulmonary hypertension Right heart catheterization
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Functional Variant in microRNA-196a2 Contributes to the Susceptibility of Congenital Heart Disease in a Chinese Population 被引量:20
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作者 XU , J. Hu, Z.B. +11 位作者 Xu, Z.F. Gu, H.Y Yi, L. Cao, H. L. Chen, J. P. Tian, T. Liang, J. Lin, Y. Qiu, W. S. Ma, H.X. Shen, H. B Chen, Y. J. 《南京医科大学学报(自然科学版)》 CAS CSCD 北大核心 2009年第11期1622-1622,共1页
关键词 中国人 心脏疾病 遗传变异 RNA
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Pulmonary Arterial Hypertension Medical Management of the Adult Patient with Congenital Heart Disease 被引量:1
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作者 Ali Ataya Julian Chung +1 位作者 Jessica Cope Hassan Alnuaimat 《Cardiovascular Innovations and Applications》 2018年第B05期1-8,共8页
Congenital heart disease(CHD)-associated pulmonary arterial hypertension(PAH)includes a heterogeneous patient population that can be characterized by the underlying cardiac malformation.CHD-associated PAH has an estim... Congenital heart disease(CHD)-associated pulmonary arterial hypertension(PAH)includes a heterogeneous patient population that can be characterized by the underlying cardiac malformation.CHD-associated PAH has an estimated prevalence of 5– 10% in adult patients,with an increasing number of patients surviving to adulthood because of advances in the surgical management and the development of pulmonary arterial hypertension(PAH)-targeted pharmacotherapy.Although limited data exist,targeted PAH pharmacotherapy has proven to be benefi cial in patients with CHD-associated PAH,with observed improvement in functional class,increase in exercise capacity,and improvement in quality of life and cardiopulmonary hemodynamics.Additionally,there has been increasing interest in the“treat-to-close”strategy.PAH-targeted pharmacotherapy may be used to optimize cardiopulmonary hemodynamics so as to improve patients’operability in repairing the cardiac defect.Although there have been signifi cant advances in the management of this disease state in the past 2 decades,mortality remains high,and ongoing clinical trials are needed to better understand the treat-to-close strategy. 展开更多
关键词 pulmonary ARTERIAL hypertension congenital heart disease EISENMENGER syndrome ARTERIAL SEPTAL DEFECT ventricular SEPTAL DEFECT
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Genetic Analysis of Variants of the MYH6 Gene Promoter in Congenital Atrial Septal Defects 被引量:1
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作者 Ji-Yang Zuo Huan-Xin Chen +2 位作者 Zhi-Gang Liu Qin Yang Guo-Wei He 《Congenital Heart Disease》 SCIE 2023年第1期7-21,共15页
Background:Atrial septal defect(ASD)is one of the common congenital heart diseases.The MYH6 gene has a critical role in cardiac development but the role of MYH6 promoter variants in patients with ASD has not been expl... Background:Atrial septal defect(ASD)is one of the common congenital heart diseases.The MYH6 gene has a critical role in cardiac development but the role of MYH6 promoter variants in patients with ASD has not been explored.Methods:In 613 subjects including 320 ASD patients,we investigated the MYH6 gene promoter variants and verified the effect on gene expression by using cellular functional experiments and bioinformatics analysis.Results:Eleven variants were identified in the MYH6 gene promoter,of which four variants were found only in ASD patients,and two variants(g.3434G>C and g.4524C>T)were identified for the first time.Cellular functional experiments indicated that all four variants reduced the transcriptional activity of the MYH6 gene promoter(p<0.05).Subsequent analysis through the JASPAR(A database of transcription factor binding profiles)suggests that these variants may alter transcription factor binding sites,which may in turn lead to changes in myocardin subunit expression and ASD formation.Conclusions:Our study for the first time focuses on variants in the promoter region of the MYH6 gene in Chinese patients with ASD and the discovered variants have functional significance.The study provides new insights in the role of the MYH6 gene promoter region to better understand the genetic basis of ASD formation and facilitates clinical diagnosis. 展开更多
关键词 Atrial septal defect MYH6 GENETIC VARIANTS congenital heart disease
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Adult Congenital Heart Disease in the Veteran Population:A Case-Based Report
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作者 Robert F.Hamburger,DO,MPH,FACC 《Cardiovascular Innovations and Applications》 2019年第B04期71-75,共5页
Simple forms of congenital heart disease can allow patients to go undiagnosed until they reach adulthood.Furthermore,improvements in care of patients with complex congenital heart disease are now allowing most patient... Simple forms of congenital heart disease can allow patients to go undiagnosed until they reach adulthood.Furthermore,improvements in care of patients with complex congenital heart disease are now allowing most patients to reach adulthood.As some patients with adult congenital heart disease can remain asymptomatic until later in life,it is possible for them to serve in the military and eventually fall under the care of Veterans Administration(VA)providers.Therefore it is important for providers,especially cardiologists at VA centers,to have fundamental understanding of the management of adult congenital heart disease.This article provides multiple cases of adult congenital heart disease experienced at a single VA medical center and reviews the anatomy,physiology,and surgical management of each condition. 展开更多
关键词 congenital heart disease atrial SEPTAL DEFECT anomalous venous return SINUS venosus DEFECT cor triatriatum TRANSPOSITION of great ARTERIES
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Ellis-Van-Creveld Syndrome and Congenital Cardiac Anomaly: Common Atrium with Atrioventricular Canal Septal Defect
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作者 Srikrishna Sirivella 《World Journal of Cardiovascular Surgery》 2021年第12期133-140,共8页
<strong>Background:</strong> <span style="font-family:;" "="">Children presenting with physical features of chondro-ectodermal</span><span style="font-family:;&... <strong>Background:</strong> <span style="font-family:;" "="">Children presenting with physical features of chondro-ectodermal</span><span style="font-family:;" "=""> dysplasia (Ellis-Van Creveld syndrome) such as skeletal and joint abnormalities often have concomitant congenital cardiac anomalies. Presence of cardiorespiratory symptoms in children with Ellis-Van Craved syndrome warrants a thorough cardiologic evaluation to recognize and treat underlying congenital heart anomaly. <b>Aim:</b> A child with physical stigmata of Ellis-Van-Creveld syndrome is evaluated to detect an associated congenital cardiac anomaly and <span>accomplish successful repair of the underlying cardiac lesion to reduce the cardiac</span> related morbidity and improve the patient survival. <b>Case Presentation:</b> Ten year</span><span style="font-family:;" "="">s</span><span style="font-family:;" "=""> old boy with chondroectodermal dysplasia (dental anomalies, genu valgum and other skeletal abnormalities) presented with dyspnea and cyanosis. Cardiac evaluation by 2D echo revealed an atrioventricular (AV) canal septal defect with AV valve regurgitation and a common atrium. Angiocardiography showed a goose neck deformity of the left ventricular outflow tract. <span>The Qp/Qs was 3.4: 1, with systemic arterial oxygen desaturation (SaO<sub>2</sub> of 0.7) </span>and O<sub>2</sub> saturation in the common atrium was 0.7. The pulmonary venous connections to the common atrium were anomalous. Atriotomy on cardiopulmonary bypass and on a cardioplegic arrest discerned a partial AV canal septal defect with a common bridging leaflet, clefts in septal leaflets of tricuspid and mitral vlalves, an incompletely closed interventricular communication, and a common atrium with highly anomalous pulmonary venous insertions well anterior (8</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">cm) to vena caval orifices. Intracardiac repair was performed with two patches of Goertex to partition the common atrium into the pulmonary and systemic venous chambers after repair of the partial AV canal septal defect. Patient required only a temporary afterload reduction with enalapril;otherwise patient had an uneventful postoperative course. At a 2</span><span style="font-family:;" "="">-</span><span style="font-family:;" "="">year follow-up, the child was well without AV valve regurgitation and had normal <span>biventricular function. <b>Conclusion:</b> A child with Ellis-Van-Creveld syndrome</span> with skeletal abnormalities and dental anomalies had manifested with cardio-respiratory symptoms. Preoperative cardiac and intraoperative evaluation showed a common atrium with severely anomalous pulmonary venous connection and partial AV canal septal defect. Successful biventricular repair was accomplished by repairing the partial AV canal septal defect and partitioning <span>the common atrium into left and right atrium by a complex atrial routing tech<span>nique with two patches of Gore-Tex. On a follow-up at 2 years</span></span></span><span style="font-family:;" "="">, </span><span style="font-family:;" "="">the patient had</span><span style="font-family:;" "=""> adequate biventricular function without AV valve regurgitation.</span> <div class="__kindeditor_paste__" style="position:absolute;width:1px;height:1px;overflow:hidden;left:-1981px;top:0px;white-space:nowrap;"> <table width="100%" border="0" cellpadding="0" cellspacing="1" bgcolor="#cacfd2" style="border:0px solid #CCCCCC;line-height:25px;width:1041px;color:#000000;font-family:宋体, Arial, sans-serif;"> <tbody> <tr style="background-color:#FAFBFD;"> <td style="text-align:center;font-size:14px;vertical-align:middle;"> <div align="center"> 114264<strong></strong> </div> </td> </tr> </tbody> </table> </div> 展开更多
关键词 CHD (congenital Heart Disease) Cyanotic CHD Great Vessel Anomalies CHD Miscellaneous Atrioventricular Septal Defects CHD and Valve Lesions
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儿童肌部室间隔缺损的介入治疗研究
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作者 胡伟 李金男 +3 位作者 杨伟 苏黎 喻卓 陈志松 《昆明医科大学学报》 CAS 2024年第3期48-53,共6页
目的探讨应用Cardi-O-Fix Plug封堵器治疗儿童肌部室间隔缺损(muscular ventricle septal defect,mVSD)的有效性和安全性。方法将昆明医科大学第一附属医院从2015年7月至2021年6月心内科收治的14例mVSD患儿作为研究对象。分为实验组(14... 目的探讨应用Cardi-O-Fix Plug封堵器治疗儿童肌部室间隔缺损(muscular ventricle septal defect,mVSD)的有效性和安全性。方法将昆明医科大学第一附属医院从2015年7月至2021年6月心内科收治的14例mVSD患儿作为研究对象。分为实验组(14例)和对照组(10例),实验组采用Cardi-O-Fix Plug封堵器进行封堵,对照组采用Cardi-O-Fix mVSD封堵器进行封堵。术后1d以及随访1个月、3个月、6个月采用经胸超声心动图和心电图评价封堵疗效及并发症的发生情况。结果24例患儿中22例成功封堵,2例封堵失败(实验组和对照组各1例),实验组成功率92.8%(13/14),对照组成功率90.0%(9/10)。实验组的平均手术时长(71.93±14.85)min,对照组的平均手术时间时长(90.70±19.78)min,二者比较差异有统计学意义(P<0.05)。实验组和对照组在术中及随访期间均未出现严重并发症。比较不同时间点2组的心脏超声指标(包括左室射血分数、左室舒张末期内径以及肺动脉压),差异均无统计学意义(P>0.05)。结论采用Cardi-O-Fix Plug封堵器在经皮导管封堵心尖部及小梁部的儿童mVSD手术安全有效,短期及中长期发生心律失常的概率低。 展开更多
关键词 室间隔缺损 肌部 封堵器 国产 经皮介入治疗 先天性心脏病 儿童
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妊娠合并房间隔缺损并发醒后卒中1例报道
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作者 钱海兰 曹小婷 +2 位作者 雷睿 周京江 袁军 《实用临床医药杂志》 CAS 2024年第2期60-62,77,共4页
妊娠期缺血性卒中发病率低、致死率高。本文通过回顾1例妊娠合并有房间隔缺损并发醒后卒中患者的临床及影像学检查资料,探讨妊娠相关卒中的影像学表现、发病机制和治疗策略,旨在提高临床医师对合并有房间隔缺损的孕妇并发急性脑卒中的认... 妊娠期缺血性卒中发病率低、致死率高。本文通过回顾1例妊娠合并有房间隔缺损并发醒后卒中患者的临床及影像学检查资料,探讨妊娠相关卒中的影像学表现、发病机制和治疗策略,旨在提高临床医师对合并有房间隔缺损的孕妇并发急性脑卒中的认识,为临床诊疗提供参考。 展开更多
关键词 妊娠 房间隔缺损 卒中 心源性脑栓塞 先天性心脏病 肺动脉高压
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Impact of Atrial Septal Defect Closure on Mortality in Older Patients
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作者 Sipawath Khamplod Yodying Kaolawanich +1 位作者 Khemajira Karaketklang Nithima Ratanasit 《Congenital Heart Disease》 SCIE 2024年第1期93-105,共13页
Background:Atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left untreated.Early closure of ASD has been associated with excellent outcomes and... Background:Atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left untreated.Early closure of ASD has been associated with excellent outcomes and lower complication rates.However,there is limited evidence regarding the prognosis of ASD closure in older adults.This study aims to evaluate the mortality rates in older ASD patients with and without closure.Methods:A retrospective cohort study was conducted on patients aged 40 years or older with ASD between 2001 and 2017.Patients were followed up to assess all-cause mortality.Univariable and multivariable analyses were performed to identify the predictors of mortality.A p-value of<0.05 was considered statistically significant.Results:The cohort consisted of 450 patients(mean age 56.6±10.4 years,77.3%female),with 66%aged between 40 and 60 years,and 34%over 60 years.Within the cohort,299 underwent ASD closure(201 with transcatheter and 98 with surgical closure).During the median follow-up duration of 7.9 years,51 patients died.The unadjusted cumulative 10-year rate of mortality was 3%in patients with ASD closure,and 28%in patients without ASD closure(log-rank p<0.001).Multivariable analysis revealed that age(hazard ratio[HR]1.04,95%confidence interval[CI]1.006–1.06,p=0.01),NYHA class(HR 2.75,95%CI 1.63–4.62,p<0.001),blood urea nitrogen(BUN)(HR 1.07,95%CI 1.03–1.12,p<0.001),right ventricular systolic pressure(RVSP)(HR 1.07,95%CI 1.003–1.04,p=0.01),and lack of ASD closure(HR 15.12,95%CI 5.63–40.59,p<0.001)were independently associated with mortality.Conclusion:ASD closure demonstrated favorable outcomes in older patients.Age,NYHA class,BUN,RVSP,and lack of ASD closure were identified as independent factors linked to mortality in this population. 展开更多
关键词 Atrial septal defect congenital heart disease defect closure long-term survival MORTALITY
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Isolated Ventricular Septal Defect: Ultrasound, Therapeutic and Evolutionary Aspects of 85 Cases in the Cardiology Department of the Ignace Deen National Hospital in Conakry
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作者 Mamadou Bassirou Bah Amadou Diouldé Doumbouya +12 位作者 Elhdj Yaya Balde Mamadou Aliou Balde Alpha Kone Ibrahima Sory Sylla Mamadou Dian Bah Aboulaye Bah Mamadou Diallo Thierno Siradjo Balde Abdoulaye Camara Morlaye Soumaoro Ibrahima Sory Barry Souleymane Diakité Mamadou Dadhi Balde 《World Journal of Cardiovascular Diseases》 CAS 2024年第8期465-479,共15页
Introduction: Ventricular septal defect (VSD) is the most common congenital heart disease of all congenital heart defects. The aim of this study was to investigate the echographic, therapeutic and evolutionary aspects... Introduction: Ventricular septal defect (VSD) is the most common congenital heart disease of all congenital heart defects. The aim of this study was to investigate the echographic, therapeutic and evolutionary aspects of ventricular septal defects (VSD) in the general cardiology department of the Hôpital National Ignace Deen. Methods: A retrospective data collection was carried out from January 2018 to December 2023 including 85 cases of isolated IVC was performed. The variables studied were epidemiological, clinical, paraclinical, therapeutic and evolutionary. Results: Of the 320 patients seen during the study period for congenital heart disease, 85 (26.556%) were isolated IVCs. Age at diagnosis ranged from 3 months to 16 years, with an average age of 3.59 years. The most represented ethnic group was the Fulani (50.58%). The 8.24% came from consanguineous marriage versus 22.35%. 91.76% of children had a history of bronchitis. The most common clinical signs found were systolic murmur (90.58%), growth retardation (51.76%). Only 4 cases (4.70%) had a malformation associated with IVC represented by DiGeorges disease (2.35%) and trisomy 21 (2.35%). Nearly half the patients had type IIb VIC (44.71%). The other half were represented by type 1 (18.82%), type IIa (20%), type III (10.59%) and type IV (5.88%). According to site more than two-thirds of VICs (71.64%) were perimembranous in location, followed by infundibular (16.47%) and muscular (11.76%) VICs. In our study 55.29% presented an indication for both surgical intervention and medical treatment, while 16.47% required only medical treatment. In contrast, 28.23% were placed under exclusive surveillance. Of the 47 patients for whom surgery was indicated, 29 (61.17%) underwent surgical repair, while 18 (38.83%) were awaiting confirmation for surgery. Conclusion: VIC is the most common congenital heart disease. An early detection strategy and the establishment of specialized centers could improve the outcome of these children. 展开更多
关键词 Ventricular Septal Defect congenital Heart Disease Ignace Deen
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房间隔缺损相关肺动脉高压机制及治疗进展
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作者 李思聪 罗勤 +2 位作者 赵智慧 赵青 柳志红 《心血管病学进展》 CAS 2024年第1期11-14,19,共5页
房间隔缺损(ASD)是常见的先天性心脏病,部分患者可能会并发肺动脉高压,对治疗和预后产生重大影响。虽然分流是先天性心脏病患者发生肺动脉高压的决定性因素,但部分患者的分流量并不足以解释肺动脉高压的严重程度。因此,阐明ASD相关肺动... 房间隔缺损(ASD)是常见的先天性心脏病,部分患者可能会并发肺动脉高压,对治疗和预后产生重大影响。虽然分流是先天性心脏病患者发生肺动脉高压的决定性因素,但部分患者的分流量并不足以解释肺动脉高压的严重程度。因此,阐明ASD相关肺动脉高压多方面的发病机制,对于认识肺动脉高压的发生发展过程和指导ASD的治疗具有重要意义。现就ASD相关肺动脉高压的病理生理学机制、危险因素和治疗策略的研究进展做一综述,为此类患者的诊治提供参考。 展开更多
关键词 先天性心脏病 房间隔缺损 肺动脉高压 发病机制
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A DiGeorge Syndrome Case Report—Challenges of Diagnosis and Management
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作者 Dumitru Amoasii 《Open Journal of Internal Medicine》 2024年第3期278-286,共9页
Background: DiGeorge syndrome (also known as velo-cardio-facial syndrome) is a rare multisystem genetic disorder occurring in approximately 1 in 4000 to 1 in 6000 live births [1]. Although advances in genetic screenin... Background: DiGeorge syndrome (also known as velo-cardio-facial syndrome) is a rare multisystem genetic disorder occurring in approximately 1 in 4000 to 1 in 6000 live births [1]. Although advances in genetic screening have improved diagnosis in developed countries, the condition remains underdiagnosed in developing nations such as the Republic of Moldova, where access to genetic testing and family planning services is limited. Routine prenatal screening usually includes regular ultrasounds, monitoring of blood pressure, complete blood counts, coagulation studies, glucose, urine protein, and urine culture. Current ultrasound techniques have limitations in detecting this syndrome due to variability in interpretation, and genetic testing is often performed based on clinical discretion. The ultrasound could potentially point towards a genetic problem, as in DiGeorge, if multiple cardiac malformations are spotted in utero, but most cases such as this one are diagnosed after birth while being described as totally normal on prenatal ultrasound. Purpose: This study aims to highlight the diagnostic challenges and the need for comprehensive evaluation in identifying DiGeorge syndrome, emphasizing the importance of considering the syndrome as a whole rather than focusing on isolated organ system issues. Method: We present a case report of a 6-month-old girl who, after an uneventful pregnancy and normal prenatal ultrasound, presented with cardiac insufficiency. Following extensive investigations and multiple surgical interventions, DiGeorge syndrome was diagnosed at 9 months of age. Results: The patient’s diagnosis was delayed due to the lack of prenatal markers and the reliance on separate investigations of affected organ systems. Despite several interventions aimed at managing her symptoms, the final diagnosis was made after observing the association of multiple clinical features and conducting comprehensive genetic testing. Conclusions: This case underscores the importance of a holistic approach to diagnosis, which involves a thorough patient history, integration of diverse diagnostic tests, and recognition of the syndrome’s multi-system nature. It highlights the necessity for improved diagnostic protocols and increased awareness in regions with limited access to advanced genetic testing to prevent delays in identifying DiGeorge syndrome and to facilitate timely and appropriate management. 展开更多
关键词 DIGEORGE Velo-Cardio-Facial TBX-1 Gene Chromosome 22 22q11.2 Deletion Septal Defect IMMUNODEFICIENCY Thymic Shadow congenital Cardiac Abnormalities Prenatal Screening
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不同介入治疗在小儿先天性心脏病室间隔缺损中的应用研究
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作者 吴晓 刘守印 《中国医学工程》 2024年第2期99-103,共5页
目的探究对小儿先天性心脏病室间隔缺损进行不同介入方式治疗的效果。方法选取南阳市第一人民医院2019年6月至2023年6月收治的80例先天性心脏病室间隔缺损患儿,按照随机法分为对照组与研究组,各40例。对照组给予患儿介入封堵术进行治疗... 目的探究对小儿先天性心脏病室间隔缺损进行不同介入方式治疗的效果。方法选取南阳市第一人民医院2019年6月至2023年6月收治的80例先天性心脏病室间隔缺损患儿,按照随机法分为对照组与研究组,各40例。对照组给予患儿介入封堵术进行治疗,研究组给予患儿经导管介入术进行治疗。对比两组患儿的临床指标、心脏功能指标、心脏彩超指标以及并发症发生率。结果研究组临床指标低于对照组(P<0.05);两组患儿治疗前后的射血分数(EF)、左室短轴缩短分数(FS)、每搏输出量(SV)以及心输出量(CO)水平比较,差异无统计学意义(P>0.05),术后患儿心脏功能表现正常(P>0.05);治疗后,研究组心脏彩超指标优于对照组(P<0.05);研究组治疗有效率高于对照组(P<0.05)。结论介入封堵术与经导管介入术在小儿先天性心脏病室间隔缺损应用中临床价值均较高,对患儿的心脏功能指标影响均较小,说明两种治疗方式均安全有效,经导管介入术的并发症发生率低于介入封堵术,对患儿创伤较小,且临床疗效高于介入封堵术,值得临床推荐。 展开更多
关键词 介入封堵术 经导管介入术 先天性心脏病 室间隔缺损 临床指标
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胸腔镜与开胸手术治疗先天性心脏病的疗效比较 被引量:21
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作者 陈海生 程云阁 +3 位作者 钟焕清 黄志辉 谢翠贤 程国栋 《中国微创外科杂志》 CSCD 2005年第8期634-635,共2页
目的比较胸腔镜与开胸手术治疗先天性心脏病的疗效。方法将62例先天性心脏病,根据患者的手术选择意愿分为2组。胸腔镜组24例,采用体外循环技术,胸腔镜下行房间隔缺损修补术8例,室间隔缺损修补术16例;开胸组38例,直视下行房间隔缺损修补... 目的比较胸腔镜与开胸手术治疗先天性心脏病的疗效。方法将62例先天性心脏病,根据患者的手术选择意愿分为2组。胸腔镜组24例,采用体外循环技术,胸腔镜下行房间隔缺损修补术8例,室间隔缺损修补术16例;开胸组38例,直视下行房间隔缺损修补术14例,室间隔缺损修补术24例。结果2组均无死亡。2组体外循环时间[(74±28)minvs.(71±24)min]、升主动脉阻闭时间[(29±13)minvs.(28±12)min]、术后呼吸机辅助时间[(3.2±1.1)hvs.(3.3±1·1)h]无显著性差异(t=0·449、0·309、-0·349;P=0·655、0·758、0·729)。2组术后并发症发生率无显著差异(χ2=2·646,P=0·104)。与开胸组比较,胸腔镜组术后胸腔引流量明显减少[(32±18)mlvs(66±28)ml;t=-5·290,P=0·000],术后住院时间明显缩短[(6·1±1·2)dvs.(7·6±2·2)d;t=-3·059,P=0·003]。结论胸腔镜手术治疗先天性心脏病创伤小,恢复快,美容效果好,安全可靠。 展开更多
关键词 胸腔镜 房间隔缺损 室间隔缺损 先天性心脏病
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超声心动图在特殊类型房间隔缺损封堵术中的应用 被引量:15
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作者 骆志玲 沈艳 +4 位作者 顾云 潘家华 王钰 喻卓 刘红明 《中国医学影像技术》 CSCD 北大核心 2009年第6期1021-1024,共4页
目的报告利用超声心动图引导下经导管房间隔缺损封堵术(TCASD)治疗特殊类型房间隔缺损(ASD)的体会。方法收集ASD病例229例,经胸和(或)经食管超声心动图(TTE、TEE)行术前筛选、ASD残边评估、封堵器(ASO)型号选择和术后随访观察。结果①... 目的报告利用超声心动图引导下经导管房间隔缺损封堵术(TCASD)治疗特殊类型房间隔缺损(ASD)的体会。方法收集ASD病例229例,经胸和(或)经食管超声心动图(TTE、TEE)行术前筛选、ASD残边评估、封堵器(ASO)型号选择和术后随访观察。结果①边缘不全型ASD141例,其中前上缘残端不全型123例,成功封堵119例(96.75%);上腔静脉残端不全型10例,均成功封堵(100%);下腔静脉残端及后壁残端不全型8例,成功封堵4例(50.00%);②巨大房缺9例,6例封堵成功(66.67%)。TEE测ASD最大径(36.30±1.90)mm(34~38mm),植入ASO大小为(39.60±2.20)mm(36~42mm);③多孔型房缺11例,其中双孔型8例,三孔型3例,均成功封堵(100%),残余分流3例(27.27%),术后12个月均消失;④合并ASA12例,其中多孔型4例,均成功封堵(100%),术后即刻残余分流2例,术后12个月随访均消失。结论TCASD治疗特殊类型ASD是安全、可行的,术前尽可能采用TEE了解ASD解剖细节是此类手术顺利成功的保证。 展开更多
关键词 超声心动描记术 心脏病 先天性 心脏间隔缺损 心房
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用Amplatzer导管封堵器介入闭合先天性膜周部室间隔缺损 被引量:15
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作者 任森根 康康 +6 位作者 吴丹宁 施红 吴锦章 杨梅 韩飞舟 周菲 朱志军 《介入放射学杂志》 CSCD 2003年第6期407-409,共3页
目的 研究Amplatzer导管封堵器 (ADO)介入闭合先天性膜周部室间隔缺损 (VSD)的可行性、安全性和有效性 ,确定其适应证和并发症。方法  2 0 0 1年 5月至 2 0 0 2年 1 2月 ,经导管闭合先天性膜周部VSD 4 1例 ,VSD直径 4~ 1 2 .8(平均 6... 目的 研究Amplatzer导管封堵器 (ADO)介入闭合先天性膜周部室间隔缺损 (VSD)的可行性、安全性和有效性 ,确定其适应证和并发症。方法  2 0 0 1年 5月至 2 0 0 2年 1 2月 ,经导管闭合先天性膜周部VSD 4 1例 ,VSD直径 4~ 1 2 .8(平均 6 .0 )mm ,其上缘距离主动脉右冠瓣 4 .5~ 1 2 (平均 6 .6 )mm。心导管资料示QP/QS 1 .4~ 2 .6 (平均 1 .7) ,肺动脉收缩压 1 9~ 34(平均 2 5 )mmHg。 4 1例膜周部VSD中 ,1 8例伴有膜部膨出瘤。结果  4 1例VSD均顺利闭合成功 ,选用的ADO尺寸为 6 / 4~ 1 6 /1 4mm。术后心脏杂音立即消失 ,选择性左心室造影及经胸超声心动图均无明显残余分流。胸片示肺血管影较术前减少。心电图有 1 2例出现不完全性右束支传导阻滞 ,1例出现完全性左束支传导阻滞 ,均在 1~ 2周内自行消失。随访 2~ 2 1个月 ,临床及实验室资料进一步改善 ,未见ADO移位、主动脉瓣或三尖瓣返流及其他并发症。结论 用ADO介入闭合先天性膜周部VSD是完全可行的 ,而且具有操作简便、安全高效。 展开更多
关键词 Amplatzer导管封堵器 介入治疗 闭合先天性膜周部室间隔缺损 适应证 并发症 心脏导管插入术
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膜部室间隔缺损介入治疗的疗效分析 被引量:16
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作者 朱鲜阳 韩秀敏 +7 位作者 侯传举 邓东安 金岩 全薇 盛晓棠 王琦光 魏明 崔春生 《介入放射学杂志》 CSCD 2004年第2期108-110,共3页
目的 评估膜部室间隔缺损 (室缺 )的导管封堵介入治疗的临床效果。方法  89例患者均有运动后心悸气短 ,胸骨左缘第 3~ 4肋间可闻及Ⅲ~Ⅳ级收缩期返流样杂音 ,肺动脉瓣区第二音增强或分裂。心电图显示左心室肥厚 17例 ,左心房增大 8... 目的 评估膜部室间隔缺损 (室缺 )的导管封堵介入治疗的临床效果。方法  89例患者均有运动后心悸气短 ,胸骨左缘第 3~ 4肋间可闻及Ⅲ~Ⅳ级收缩期返流样杂音 ,肺动脉瓣区第二音增强或分裂。心电图显示左心室肥厚 17例 ,左心房增大 8例。超声心动图证实为膜部室缺。左心室造影测量室缺直径为 3~ 10 (4 .9± 1.8)mm ,室缺上缘距主动脉瓣下缘 1~ 5 (2 .3± 0 .9)mm ,36例合并有膜部室间隔膨出瘤 ,2例合并动脉导管未闭 (PDA)和 1例并轻度主动脉瓣关闭不全。选用Judkins右冠状动脉导管和Terumo导丝 ,通过室缺建立轨道 ,82例采用膜部室缺封堵器 6~ 14型号封堵 ,7例选用PDA蘑菇伞封堵 ,合并PDA者先行室缺封堵而后堵闭PDA。结果  88例介入治疗成功 ,6 7例即刻无分流 ,2 1例有少量分流 ,1例室缺术后封堵器脱落 ,经导管取出后行外科手术修复室缺 ,无其他严重并发症。随访 1~ 15个月无异常表现。结论 在严格选择适应证和有熟练操作技巧的条件下 ,膜部室缺封堵术是一项操作安全、疗效可靠的治疗方法 。 展开更多
关键词 膜部 室间隔缺损 介入治疗 先天性心脏病 超声心动图
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超声心动图引导下经皮房间隔缺损封堵术的临床评估 被引量:17
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作者 卢衡 陈良万 +2 位作者 张贵灿 廖东山 王齐敏 《中南大学学报(医学版)》 CAS CSCD 北大核心 2015年第6期646-650,共5页
目的:探讨经胸超声心动图(transthoracic echocardiography,TTE)和/或经食道超声心动图(transesophageal echocardi-ography,TEE)引导下经皮房间隔缺损封堵术的安全性及有效性。方法:选取2014年1—12月福建医科大学附属协和医院心血管... 目的:探讨经胸超声心动图(transthoracic echocardiography,TTE)和/或经食道超声心动图(transesophageal echocardi-ography,TEE)引导下经皮房间隔缺损封堵术的安全性及有效性。方法:选取2014年1—12月福建医科大学附属协和医院心血管外科单纯性继发孔型房间隔缺损患者32例,均在TTE和/或TEE监测下行经皮房间隔缺损封堵术。结果:32例患者全部封堵成功,1例术后即刻TT E复查存在少量残余分流,术后1个月复查示残余分流消失。其余31例患者在术后即刻、1个月、3个月复查TT E,均未见封堵器移位、残余分流等并发症。结论:超声心动图引导下经皮封堵房间隔缺损是一种微创、安全、有效的新型手术方法。 展开更多
关键词 房间隔缺损 超声心动描记术 封堵器 先天性心脏病
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三尖瓣腱索附着异常的膜周部室间隔缺损介入治疗初步探讨 被引量:10
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作者 杜亚娟 张玉顺 +2 位作者 成革胜 李巍 和旭梅 《中国循环杂志》 CSCD 北大核心 2011年第2期133-136,共4页
目的:探讨三尖瓣腱索附着异常的膜周部室间隔缺损(VSD)应用特制的"类柱状封堵器"介入治疗的可行性及近期疗效观察。方法:术前超声检查筛选出5例VSD的患者均伴有三尖瓣腱索附着异常。5例患者均选择特制"类柱状封堵器"... 目的:探讨三尖瓣腱索附着异常的膜周部室间隔缺损(VSD)应用特制的"类柱状封堵器"介入治疗的可行性及近期疗效观察。方法:术前超声检查筛选出5例VSD的患者均伴有三尖瓣腱索附着异常。5例患者均选择特制"类柱状封堵器"堵闭VSD。术后24 h、1个月、6个月行超声心动图、心电图检查随访观察。结果:5例患者均一次封堵成功。术后复查心电图,未发现严重新发的心律失常。术后24 h超声心动图检查,封堵器形态、位置良好;4例心腔大小较术前均有所缩小,1例缺损较小,心腔大小正常无明显变化;三尖瓣反流1例较术前增多。术后6个月超声心动图检查,4例心腔大小均回缩至正常;1例心腔大小正常患者无明显变化;1例较术前三尖瓣反流量增多患者术后1个月、6个月均无明显变化;无其他并发症发生。结论:特制"类柱状封堵器"可用于三尖瓣腱索附着异常的膜周部VSD介入治疗中,即刻及近期疗效可靠,未发现严重的三尖瓣反流及其他并发症。 展开更多
关键词 超声心动图 室间隔缺损 介入治疗
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雷米芬太尼在全电视胸腔镜下小儿先天性心脏病手术快通道麻醉的应用探讨 被引量:11
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作者 檀文好 黎必万 +2 位作者 莫伟波 黄庆 梁军 《中国内镜杂志》 CSCD 北大核心 2013年第11期1136-1140,共5页
目的探讨雷米芬太尼在全电视胸腔镜下小儿先天性心脏病手术快通道麻醉的可行性及安全性。方法随机选择采取股动静脉插管、建立体外循环、右胸胸壁打3个小孔后施行全电视胸腔镜房间隔缺损或单纯室间隔缺损修补术的小儿心脏病患者120例,AS... 目的探讨雷米芬太尼在全电视胸腔镜下小儿先天性心脏病手术快通道麻醉的可行性及安全性。方法随机选择采取股动静脉插管、建立体外循环、右胸胸壁打3个小孔后施行全电视胸腔镜房间隔缺损或单纯室间隔缺损修补术的小儿心脏病患者120例,ASAⅠ、Ⅱ级。按随机数字表法分雷米芬太尼快通道麻醉组(RF组,n=60)和芬太尼常规麻醉组(F组,n=60),两组均采用全身麻醉单腔气管插管低温体外循环下手术。记录两组患者麻醉期间各时点血流动力学及血气分析变化情况和术后恢复情况。结果两组患儿手术顺利,无重要并发症。RF组与F组在诱导后10 min、转机即刻、停机后10 min和手术结束等时间点上各血流动力学指标差异无显著性(P>0.05)。两组动脉血气分析各项指标在正常值范围,差异均无显著性(P>0.05)。RF组患者术后清醒时间、气管导管拔管时间及ICU留观时间明显短于F组(P<0.05),而RP组术后疼痛发生率高于F组。结论雷米芬太尼用于全电视胸腔镜下先天性心脏病手术快通道麻醉能保持术中血流动力学的稳定,停药后清醒快,是一种安全、有效的心脏麻醉方法。 展开更多
关键词 快通道麻醉 电视胸腔镜 先天性心脏病 室间隔缺损 房间隔缺损
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