摘要
目的:研究先天性心脏病复合畸形经导管介入治疗策略并评价其疗效。方法:先天性心脏病复合畸形57例,复合类型为:膜部室间隔缺损(VSD)并房间隔缺损(ASD)21例,VSD并动脉导管未闭(PDA)4例,ASD并PDA8例,ASD并肺动脉瓣狭窄(PS)22例,VSD并PS2例。复合畸形同期介入治疗顺序依次为:PS球囊扩张术,VSD封堵术,PDA封堵术,最后行ASD封堵术。结果:57例患者中,除1例因PDA过小,导丝无法通过未闭导管,在VSD成功封堵后放弃PDA封堵。56例患者同期经导管介入治疗均获成功,术中未发生任何重要并发症。术后造影及超声检查VSD、ASD及PDA均无残余分流,封堵器固定好。并发PS的24例患者,跨肺动脉瓣压差由术前(96.0±30.0)mmHg(1mmHg=0.133kPa)下降到术后平均(15.6±3.3)mmHg(P<0.01)。术后3d、1个月、6个月及1年分别行经胸超声心动图、心电图、X线检查,全部患者无残余分流,封堵器位置固定良好,跨瓣压差均在正常范围内,无任何并发症发生。结论:先天性心脏病复合畸形经导管介入治疗安全有效,值得推广。
Objective：To evaluate the efficacy of interventional therapy for the combined congenital heart diseases （CHD）. Method：Transcatheter closures were performed in 57 patients with the combined defects in this study, including 21 patients with perimembranous ventricular septal defect （VSD） and atrial septal defect （ASD）, 4 patients with VSD and ductus arteriosus（PDA）, 8 patients with ASD and PDA, 22 patients with ASD and pulmonary stenosis （PS） and 2 patients with VSD and PS. The sequence of interventional therapy for the complex malformations was in order of PS, VSD, PDA and ASD. Result：Without severe complications, 56 patients were treated successfully except one patient with VSD and PDA. We only closed his VSD successfully and gave up closing the PDA because the diameter of PDA is too small to let the wire get through. The results of the left ventricular angiography and transthoracic echocardiography （TTE） that performed fifteen minutes after the procedure showed that there was no residual shunt flow in the patients with VSD, ASD and PDA and the occluders fixed well. In the 24 patients complicated with PS, the systolic pressure gradient across the pulmonary valve decreased from （96.0±30.0） mmHg （1mmHg=0. 133 kPa） to （15.6±3.3）mmHg and the difference was significant （P〈0.01）. The TTE, electrocardiography and fluoroscopy were scheduled before and at 1,6 and 12 months after discharge for the followup. All of the patients had no residual shunt flow, all the occluders fixed well, the systolic pressure gradient across the pulmonary valve were all in the normal range and there was no complication during the follow up in all patients. Conclusion：Interventional therapy is safe and effective in patient with combined congential neart diseases than that of the single lesims.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2007年第6期430-432,共3页
Journal of Clinical Cardiology
关键词
心脏缺损
先天性
介入治疗
封堵器
Heart defects, congenital
Transcatheter closure
Occluder
