摘要
目的探讨膜周部室间隔缺损(perimembranous ventricular septal defect,PMVSD)经导管封堵术后三尖瓣反流的发生与转归。方法选取2007年1月至2012年3月在我院心内科诊断为PMVSD并成功行经导管介入封堵治疗的患者332例,其中男182例,年龄(15.4±12.3)岁。分别在经导管封堵术前、术后3天及1、3、6、12个月行经胸超声心动图(transthoracic echocardiography,TTE)检查,观察有无三尖瓣反流及其程度。并根据所用封堵器类型分为2组:对称型封堵器组和细腰型封堵器组,并比较两组三尖瓣反流的发生率。结果 332例患者中181例使用对称型封堵器,另151例使用细腰型封堵器。术后共有14例(4.2%)新出现三尖瓣反流或原有三尖瓣反流加重,其中对称型封堵器组8例(4.4%),细腰型封堵器组6例(4.0%),二者之间无明显差异(P=0.84);随访时间(12.1±7.9)个月,有3例患者三尖瓣反流程度较出院时减轻。无因三尖瓣腱索断裂或瓣膜毁损导致三尖瓣关闭不全的患者。结论 PMVSD经导管封堵术后少数患者可发生三尖瓣反流,其发生与封堵器类型无关,反流程度一般不随时间推移而加重,预后较好。
Objective To investigate the occurrence and outcome of tricuspid regurgitation after tran- scatheter closure of perimembranous ventricular septal defect （PMVSD）. Methods From January 2007 to March 2012, 332 patients diagnosed as PMVSD and successfully underwent transcatheter interventional therapy in the Southwest Hospital were enrolled, including 182 male patients with an average age of 15.4 ±12.3 years. Transthoracic echocardiography （TTE） was applied to observe the tricuspid regurgitation and its degree before procedure, in 3 d after procedure, and during 1-, 3-, 6- and 12-month follow-up. The patients were divided into two groups based on the devices applied： a symmetric occluder group and a small-waist occluder group, and the incidence of tricuspid regurgitation in the two groups were compared. Results In the 332 patients, 181 patients used the symmetric occluders and 151 patients used the small-waist occluders. After procedure, new tricuspid regurgitation or aggregation of primary tricuspid regurgitation were observed in 14 patients （4.2%）. There were 8 patients （4.4%） in the symmetric occluder group and 6 patients （4.0%） in the small-waist oecluder group, and the difference between the two groups was no statistically significant （P = 0.84）. During the follow-up for （12.1± 7.9） months on average, 3 patients＇ tricuspid regurgitation mitigated. There was no tricuspid regurgitation induced by tricuspid chordae fracture or valve damage. Conclusion After tran- scatheter closure of PMVSD, a small number of patients may develop tricuspid regurgitation, which is unrelated to the types of occluders. The regurgitation generally does not aggravate over time, and the outcome is good.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2013年第12期1294-1296,共3页
Journal of Third Military Medical University
关键词
室间隔缺损
膜周部
介入治疗
三尖瓣反流
ventricular septal defect
perimembranous
interventional therapy
tricuspid regurgitation
