摘要
目的探讨经导管介入治疗先天性心脏复合畸形的临床疗效与安全性。方法选取19例（男性9例，女性10例，年龄4—37岁）心脏复合畸形患者，包括：室间隔缺损（ventricular septal defect，VSD）合并动脉导管未闭（patent ductus arteriosus，PDA）7例，VSD合并房间隔缺损（atrial septal defect，ASD）5例，ASD合并PDA4例，ASD合并肺动脉瓣狭窄（pulmonary stenosis，PS）2例，先天性主动脉缩窄合并PDA1例。按照“先难后易，先复杂后简单”的原则进行介入治疗操作，先行Ps球囊扩张术，再行VSD封堵术，后行PDA封堵术及ASD封堵术。分别于术后第4天、1、2、6个月及1年复查心电图及心脏超声等。结果19例患者经导管介入治疗均获成功，其中16例分别植入2个封堵器，2例ASD合并Ps患者成功地进行了肺动脉瓣球囊扩张术后及ASD封堵术，1例先天性主动脉缩窄合并PDA患者经球囊扩张及带膜支架植入治疗获得成功。平均随访（15．5±9．4）个月（1个月至3年），术后未见严重并发症发生。结论对先天性心脏复合畸形，只要严格掌握介入治疗适应证，遵循适当的手术方略，选择正确的操作顺序和方法，可以通过介入治疗手段一次性根治。
Objective To probe the safety and clinical results of transcatheter intervention therapy in patients with combined congenital heart deformities. Methods Nineteen patients （9 male and 10 female, aged 4 to 37 years） with combined congenital heart diseases underwent transcatheter intervention therapy. Seven pa- tients were of ventricular septal defect （VSD） and patent ductus arteriosus （PDA） , 5 patients of VSD and atrial septal defect （ASD）, 4 of ASD and PDA, 2 of ASD and pulmonary stenosis （PS）, 1 of PDA and congenital coarctation of aorta. The principle of intervention therapy was ＂the difficulty first then the easy, the complex first then the simple＂. That is, first balloon valvoplasty of PS was performed, secondly transcatheter closure of VSD, lastly transcatheter closure of PDA or ASD. The electrocardiogram and ecbocardiograpby were rechecked at 4 days, 1,2, 6 and 12 months after intervention therapy during follow-up. Results Transcatbeter intervention therapy was successfully performed in all of 19 cases. Two closure devices were implanted in each one of 16 patients. Pulmonary balloon valvoplasty and ASD closure was simultaneously performed in 2 patients, balloonexpandable graft-stent implantation in 1 patient with coarctation of aorta and PDA successfully. Average followup period was （ 15.5 ± 9.4） months （ from 3 months to 3 years）. No severe complications occurred in follow-up period. Conclusion Combined congenital heart deformities could be simultaneously managed by transcatheter intervention therapy. The indications of intervention therapy should be strictly controlled and the methodology of interventional procedure is skillfully applied.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2006年第15期1624-1626,共3页
Journal of Third Military Medical University
基金
第三军医大学西南医院临床研究资助项目(SW2004017)~~
关键词
心脏畸形
先天性
心脏导管插入术
封堵器
heart deformity, congenital
heart catheterization
interventional therapy
