摘要
目的 评价应用国产偏心型室间隔缺损 (VSD)封堵器经导管治疗嵴内型 (IVSD)和肺动脉瓣下型室间隔缺损 (SVSD)的疗效和安全性。方法 2 8例VSD患者 ,其中IVSD 2 2例 ,SVSD 6例。封堵器由 2个圆形盘片和连接腰组成 ,腰部长 2mm ,两侧盘片呈不对称型 ,左心室侧的盘片呈偏心型 ,靠主动脉侧的边缘为 0mm ,与其相对的边缘为 6mm ,右心室的盘片比腰部直径大 4mm。在X线透视和经胸超声引导下 ,经 7～ 10F鞘管通过股静脉途径放置封堵器。结果 左心室造影测量的缺损直径 2～ 12mm ,平均(4 .4 5± 1.93)mm。缺损上缘距主动脉瓣 0～ 1mm ,平均 (0 .35± 0 .5 )mm。 2 2例IVSSD患者封堵全部成功 ,6例SVSD中 4例封堵治疗成功 ,1例合并微量主动脉瓣返流。 2例因缺损大而放弃封堵治疗。未发生其他并发症。X线曝光时间 9～ 4 0min ,平均 (14 .1± 5 .2 )min ,操作时间 4 0～ 15 0min ,平均 (5 9.8± 17.8)mm。结论 国产偏心型VSD封堵器可以成功封堵IVSD和部分SVSD ,近期疗效佳 ,远期疗效需要进一步随访观察。
Objective To assess the efficacy and safety of transcatheter closure of intracristal ventricular septal defect (IVSD) and subpulmonary ventricular septal defect (SVSD) with home-made eccentric nitinol occluder.Methods Transcatheter closure was attempted in 28 patients (15 men and 13 women), with IVSD (n=22) and SVSD (n=6) at an average of 12.44 ±5.86 years (ranged from 3 to 34 years of age). The homemade device consists of two low profile disks made of Nitinol wire mesh with a 2 mm connecting waist. The left disk is 6 mm towards the apex and 0 mm towards the aortic valve. The right disk is 4 mm larger than the diameter of the waist. The devices were depolyed via the femoral vein using 7-10 Fr sheaths under the guidance of transthoracic echocardiography and fluoroscopy. Results The VSD average diameter was 4.54 ±1.93mm (ranged 2 to 12 mm) with the distance of VSD to aortic valve averaging 0.35 ±0.45mm (range 0 to 1 mm) and the connecting waist diameter of device of 7.65 ±3.11 mm (ranged 4 to 14 mm). The device was implanted successfully in 26 of 28 procedures. A trivial aortic regurgitation occurred in 1 patient with SVSD after deployment of the occluder. Implantation was unsuccessful in 2 patients with SVSD having large septal defects. No other complications were observed. The mean fluoroscopy time for the procedure was 14.07 ±5.19 min (range 9 to 40 min) and the whole procedure time was 59.81 ±17.76min(range 40 to 150 min).Conclusions Transcatheter closure of IVSD and SVSD with homemade eccentric nitinol occluder is effective, easy and safe. Longer term follow-up is necessary for assessing the efficacy.
出处
《介入放射学杂志》
CSCD
2004年第6期486-489,共4页
Journal of Interventional Radiology
