目的 探讨本中心采用国产封堵器治疗房间隔缺损(atrial septum defect，ASD)的疗效及并发症。方法 选择在本中心就诊的2002-09至2013-12应用国产封堵器治疗的712例继发孔型房间隔缺损的患者，其中男247例，女465例;年龄3~67岁，体重12~70 kg。结果 手术成功率99.0%(705/712)。5例因缺损直径较大或边缘不足导致试封堵失败，择期性行外科手术修补治疗;2例释放后即发现封堵器移位，立即通知外科及时开胸手术;置入封堵器直径为10~44 mm，中位封堵器直径28 mm。特殊病例有:20例多孔，1例合并房间隔膨出瘤;12例房间隔缺损合并室缺同期行介入治疗，6例房间隔缺损合并PDA同期介入治疗。近期并发症包括: 封堵器移位(2例)，心律失常(3例)，无脑梗死或空气栓塞，平均2.2年(1~4年)的随访中出现1例Ⅲ度房室传导阻滞(AVB)。结论 ASD应用国产封堵器经导管介入治疗技术成功率高，近远期疗效均满意。
Abstract
Objective To assess the curative effect and complications of adopting domestic sealing device for the treatment of atrial septum defect (ASD)in this center.Methods From September 2002 to December 2013, this center recruited 712 patients with ostium secundum defect with domestic sealing device, among whom 247 were males.Their age was from 3 to 67 and the body quality was from 12 to 70 kg.Results The surgical success rate was 99.0% (705/712). 5 cases failed due to the diameter of the defect or insufficient edge, so they had to choose surgical repair treatment. The occluders in 2 cases shifted after release, so we immediately asked cardiac surgery for thoracotomy;the diameter of occluders inserted in was from 10 to 44 mm with a mean of 28 mm. Special cases were: 20 cases of porous ASD, 1 case of atrial septal aneurysm;12 cases of ventricular septal defect and 6 patients with combined PDA were cured by interventional therapy.Recent complications included occluder shift (2 cases), cardiac arrhythmia (3 cases) and no cerebral infarction or air embolism.After following-up for an average of 2.2 years (1-4 years of follow-up) only 1 case was found with Ⅲ degree atrioventricular block (AVB).Conclusions Transcatheter interventional treatment adopting domestic sealing device of ASD has high success rate and satisfactory curative effect.
关键词
房间隔缺损 /
介入治疗 /
先天性心脏病 /
并发症
Key words
atrial septal defect /
interventional therapy /
congenital heart disease /
complications
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参考文献
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基金
武警总医院一类课题基金(WZ20130502)
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