摘要
目的:探讨封堵器治疗多出口膜部瘤型室间隔缺损(VSD)的可行性、安全性和疗效,并总结其技术难点和临床策略。方法:对我院行封堵治疗的53例多出口膜部瘤型VSD患者临床资料进行回顾性分析。结果:51例患者封堵成功,成功率96.2%;术后发生少量残余分流4例,其中3例48h后分流消失,另1例1个月随访时亦消失;术后2例出现完全性右束支传导阻滞,2例完全性左束支传导阻滞,1例一过性Ⅲ度房室传导阻滞,出院前均恢复;左室舒张末期内径由封堵前的(48.1±5.3)mm下降为封堵后的(45.7±5.3)mm(P=0.001);术后6个月随访无迟发性心律失常、瓣膜受损及猝死事件。结论:介入封堵治疗多出口膜部瘤型VSD安全有效,近期疗效好,技术关键是通过对膜部瘤的位置、形态、破口大小、数目及距主动脉瓣距离等情况判断封堵部位及选择合适的封堵器。
Objective：To discuss the feasibility,safety and curative effect of interventional occlusion for multi- ple outlets sac-type membranous ventricular septal defection （VSD）,and summarize the technical difficulty and clinical strategy.Method：Fifty-three cases with multiple outlets sac-type membranous VSD were analyzed retro- spectively.Result：Fifty-one cases were successfully cured,the successful rate was 96.2%.Mild bypass flow was found in four cases after occlusion,and three disappeared within 48hours,other one disappeared within one month reported by follow up.After occlusion,two cases were complete right bundle branch block,two cases were com- plete left bundle branch block,and one case was third degree atrioventricular block.All were healed completely before discharge.Left ventricular end-diastolic diameter before and after occlusion was（48.1±5.3）mm and （45.7± 5.3）mm （P=0.001）respectively.There was no delayed cardiac arrhythmia,value damage or sudden death occurred within six month after occlusion.Conclusion：Interventional occlusion for multiple outlets sac-type mem- branous VSD is safe and effective.The key technique is to find the location for occlusion and choose the right occluder according to the following characters of membranous aneurysm,which includes location,shape,size of the breach,number and the distance to aortic value,etc.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2013年第6期446-448,共3页
Journal of Clinical Cardiology
关键词
室间隔缺损
膜部瘤
封堵器
介入性
ventricular septal defect
membranous aneurysm
occluder
interventional
