摘要
目的：研究小儿复合型先天性心脏病经导管介入治疗的方法及疗效。方法：1994年3月至2003年12月适合经导管介入治疗的复合型先天性心脏病患儿15例，肺动脉瓣狭窄（PS）伴房间隔缺损（ASD）或动脉导管未闭（PDA）者，先行PS瓣膜成形术，再堵塞ASD或PDA；主动脉缩窄（COA）伴PDA者，先行COA血管成形术，4～15个月后再行PDA堵塞术；主动脉瓣狭窄（AS）伴PDA者，先行瓣膜成形术，再行PDA堵塞；室间隔缺损（VSD）伴PDA采用弹簧圈封堵。结果：15例患者经导管介入治疗均获成功。除2例PDA术后即刻有少量紊流，余均无残漏。随访（3．57±2．61）年，跨瓣（或跨缩窄段）压差经超声心动图或导管测压除AS外均正常。围术期机械性溶血、弹簧圈脱落和动脉栓塞各1例。结论：复合型先天性心脏病经导管介入治疗只要恰当掌握指征，操作规范，可获得良好的治疗效果；对合并AS者，适应证的掌握及球囊大小的选择需进一步摸索。
Objective： To investigate the methods of interventional catheterization for combined congenital heart disease and to evaluate its efficacy in children. Methods： From March 1994 to December 2003, 15 cases （6 boys, 9 girls） underwent transcatheter intervention for combined congenital heart diseases. The procedure of transcatheter intervention was as follows： for pulmonary stenosis （PS） and atrial septal defect （ASD） or patent ductus arteriosus （PDA）, PBPV first,occlusion of ASD or PDA later ; for coarctation of aorta （COA） and PDA,dilation of COA first,occlusion of PDA 4-15 months later; for aortic stenosis （AS） and PDA,PBAV first, occlusion of PDA later; for ventricular septal defect （VSD） and PDA, all occlusions with detachable coils. Results： Transcatheter intervention for combined congenital heart diseases was successful in all patients. There was no residual shunt after occlusion immediately apart from 2 cases of PDA which were little residual after occlusion immediately. Follow-up for （3.57±2.61） years, the systolic pressure gradients across pulmonary valve and coarctation were normal by ultrasonic or transcatheter,except AS. There was 3 cases presented postoperative complications： 1 with mechanical haemolysis, 1 with fall off of coil and 1 with arterial embolism, respectively. Conclusion： Transcatheter intervention for combined congenital heart diseases could obtain satisfactory results with appropriate indications and procedure manipulations.
出处
《浙江大学学报（医学版）》
CAS
CSCD
2006年第3期327-330,共4页
Journal of Zhejiang University(Medical Sciences)
