Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical ...Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical data for transcatheter occlusion(TCO,n=63),transthoracic occlusion(TTO,n=55),and right anterolateral minithoracotomy(RALT,n=60)techniques used for ASD closure.We compared the safety and efficacy of the three approaches.Results:ASD size in the TTO group was similar to that in the RALT group(P=0.645)and significantly larger than that in the TCO group(P<O.OO1).The RALT group had more non-central types of ASD than the TTO and TCO groups(P=O.019 and P<O.OO1).The operative time in the TTO group was shorter than that in the TCO and RALT groups(P<O.OO1 and P<0.001).The ventilation time and intensive care unit duration were shorter in the TTO group than in the RALT group(P<O.OO1 and P<O.OO1).Hospital duration in the TCO group was shorter than that in the TTO and RALT groups(P<O.OO1 and P<O.OO1).There were no residual shunt and mortality in any group in hospital or during follow-up.There was no significant difference in the incidence of total complications among the three groups(P=0.738).Conclusion:TCO,TTO,and RALT can be performed with favorable cosmetic and clinical results for closing ASD.Appropriate patient selection is an important factor for successful closure.These techniques are promising alternatives to standard median sternotomy and merit additional study.展开更多
目的比较经食管超声心动图(transesophageal echocardiography,TEE)与经胸超声心动图(transthoracic echocardiography,TTE)引导行经皮介入封堵术治疗继发孔型房间隔缺损(ostium secundum defect,OSD)的临床效果。方法选择84例继发孔型...目的比较经食管超声心动图(transesophageal echocardiography,TEE)与经胸超声心动图(transthoracic echocardiography,TTE)引导行经皮介入封堵术治疗继发孔型房间隔缺损(ostium secundum defect,OSD)的临床效果。方法选择84例继发孔型OSD患者,术前行TTE及TEE检查。根据术中影像学引导技术的不同分为TEE组(44例)和TTE组(40例),分别在TEE和TTE引导下行经皮介入封堵术。比较两组围术期指标、封堵成功率、一次封堵器选择成功率及术后并发症情况。结果两组患者封堵手术均成功。TEE及TTE测量OSD最大内径值存在统计学差异(P<0.05),而两者测量房顶缘残端、主动脉根部残端以及心房总长度等参数比较差异均无统计学意义(P>0.05)。TEE组手术时间、心内操作时间少于TTE组(P<0.05),一次封堵器选择成功率高于TTE组(P<0.05),而两组住院时间及封堵成功率比较均无统计学差异(P>0.05)。所有患者术后随访12个月,均无心包积液及血管损伤发生。TEE组发生残余分流及皮下气肿各1例,TTE组发生胸腔积液及皮下气肿各1例,两组比较差异无统计学意义(P>0.05)。结论TEE引导下行经皮封堵术治疗继发孔型OSD,测量参数准确,操作时间较短,封堵效果满意,安全性良好。展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81873502 and No.31330029).
文摘Objective:The aims of this retrospective study were to investigate and evaluate the safety and efficacy of three approaches for closure of secundum atrial septal defect(ASD).Methods:In this study,we reviewed clinical data for transcatheter occlusion(TCO,n=63),transthoracic occlusion(TTO,n=55),and right anterolateral minithoracotomy(RALT,n=60)techniques used for ASD closure.We compared the safety and efficacy of the three approaches.Results:ASD size in the TTO group was similar to that in the RALT group(P=0.645)and significantly larger than that in the TCO group(P<O.OO1).The RALT group had more non-central types of ASD than the TTO and TCO groups(P=O.019 and P<O.OO1).The operative time in the TTO group was shorter than that in the TCO and RALT groups(P<O.OO1 and P<0.001).The ventilation time and intensive care unit duration were shorter in the TTO group than in the RALT group(P<O.OO1 and P<O.OO1).Hospital duration in the TCO group was shorter than that in the TTO and RALT groups(P<O.OO1 and P<O.OO1).There were no residual shunt and mortality in any group in hospital or during follow-up.There was no significant difference in the incidence of total complications among the three groups(P=0.738).Conclusion:TCO,TTO,and RALT can be performed with favorable cosmetic and clinical results for closing ASD.Appropriate patient selection is an important factor for successful closure.These techniques are promising alternatives to standard median sternotomy and merit additional study.
文摘目的比较经食管超声心动图(transesophageal echocardiography,TEE)与经胸超声心动图(transthoracic echocardiography,TTE)引导行经皮介入封堵术治疗继发孔型房间隔缺损(ostium secundum defect,OSD)的临床效果。方法选择84例继发孔型OSD患者,术前行TTE及TEE检查。根据术中影像学引导技术的不同分为TEE组(44例)和TTE组(40例),分别在TEE和TTE引导下行经皮介入封堵术。比较两组围术期指标、封堵成功率、一次封堵器选择成功率及术后并发症情况。结果两组患者封堵手术均成功。TEE及TTE测量OSD最大内径值存在统计学差异(P<0.05),而两者测量房顶缘残端、主动脉根部残端以及心房总长度等参数比较差异均无统计学意义(P>0.05)。TEE组手术时间、心内操作时间少于TTE组(P<0.05),一次封堵器选择成功率高于TTE组(P<0.05),而两组住院时间及封堵成功率比较均无统计学差异(P>0.05)。所有患者术后随访12个月,均无心包积液及血管损伤发生。TEE组发生残余分流及皮下气肿各1例,TTE组发生胸腔积液及皮下气肿各1例,两组比较差异无统计学意义(P>0.05)。结论TEE引导下行经皮封堵术治疗继发孔型OSD,测量参数准确,操作时间较短,封堵效果满意,安全性良好。
