摘要
目的:探讨室间隔缺损(VSD)外科修补术后残余漏介入治疗的方法学及临床疗效。方法:对年龄在7～58岁之间的12例VSD修补术后残余漏患者行介入治疗。封堵材料为Amplatzer非对称性室间隔缺损封堵器(AAVSDO)和对称性国产室间隔缺损封堵器(VSDO)。距手术修补时间平均为(10.2±5.5)年;9例为膜部室间隔缺损修补术后患者,3例为法乐四联征(TOF)术后患者;8例修补术后心电图示完全性右束支传导阻滞(CRBBB),1例修补术后出现Ⅲ度房室传导阻滞并安装了永久起搏器。以经食道超声(TEE)或经胸超声(TTE)以及左心室造影测量残余漏大小。9例患者各有1个残余漏口,3例患者右心室面有两个残余漏口。结果:超声及左心室造影所测残余漏直径分别为3～10 mm和4～10 mm,所选用封堵器直径为4～12 mm,封堵15分钟后造影示11例残余漏完全封堵,1例残留少量分流,术后1个月复查时残余分流消失。所有患者未出现新的心律失常及其它并发症。结论:介入治疗室间隔缺损修补术后残余漏安全有效,其远期效果需长期随访观察。
Objective ： To discuss the method and effect of percutaneous closure of residual shunts after surgery repair of ventricular septal defect（VSD）.
Methods ： Twelve patients, aged 7-58 years, with residual shunts after surgery repair of VSD underwent percutaneous closure with Amplatzer asymmetric ventricular septal defect occluder（AAVSDO） or domestic symmetric ventricular septal defect occluder （ VSDO）, mean 10. 2 years after surgical repair. 9 following membranous VSD, and 3 following tetralogy of fallot （TOF）. Eight patients developed complete right bundle-branch block, and 1 had a permanent cardiac pacemaker for his acquired Ⅲ-degree AV block after VSD repair. The diameter of residual shunt was measured by TEE or TIE and angled angiocardiography. Nine had only 1 residual shunt,and the other 3 had 2 residual shunts.
Results： The residual shunts diameter ranged from 3-10 mm by TEE and 4-10 mm by angiocardiography. The device diameter ranged from 4-12 mm. There was no residual shunt in 11 of 12 patients 15 minutes after deployment of prosthesis. One patient had a trivial residual shunt disappearing 1 month after procedure. No newly developed arrhythmia or other complications were observed in all patients.
Conclusions： Percutaneous closure of residual shunt after VSD repair is safe and effective. Further follow-up is needed to document its long-term results.
出处
《中国循环杂志》
CSCD
北大核心
2006年第6期441-444,共4页
Chinese Circulation Journal
关键词
室间隔缺损
残余漏
介入性
Ventricular septal defect
Residual shunt
Interventional
