摘要
目的 评价自制非对称型室间隔缺损 (VSD)封堵器经导管闭合VSD的可行性及疗效。方法 16例患者经临床体检、心脏超声检查诊断为先天性心脏病 ,膜周部VSD。术前超声测量缺损直径 3～ 8(4 .31± 1.35 )mm。在X线透视和经胸超声引导下通过F6～ 8长鞘置入封堵器。结果 左心室造影测量VSD直径为 3～ 8(4 .6 3± 1.5 9)mm。VSD上缘距主动脉瓣 1～ 6 (3.31± 1.19)mm。植入封堵器腰部直径为 4～ 16 (6 .19± 1.91)mm。 14例封堵器到位后 15min左心室造影示无分流 ,2例少量分流。术后 1周经胸超声检查无分流 ,术中及术后无并发症。结论 应用自制非对称型VSD封堵器治疗膜周部VSD安全、有效。远期疗效尚需进一步随访观察。
Objective To evaluate the efficacy and safety of transcatheter closure of perimembranous ventricular septal defects (VSD) using home-made nitinol asymmetric two-disk occluder.Methods Trans-catheter closure was attempted in 16 patients with perimembranous ventricular septal defect at a mean age of (16.8 ±11.2) years (range from 5 to 37 years). All patients were diagnosed by the physical examination, echocardiography and left ventriculography. The mean VSD narrowest diameter was (4.31 ±1.35)mm (range from 3 to 8mm) by echocardiography. A 6—8F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein approach. Left ventriculography and transthoracic echocardiography were repeated to assess the efficacy of the closure, 15min after the procedure. Results The mean VSD narrowest diameter was (4.63 ±1.59)mm (range from 3 to 8 mm) measured by left ventriculography. The distance of upper rim of VSD to aortic valve was 1? ?.6 ( 3.31 ±1.9) mm. The devices were successfully deployed in all patients. The diameter of occluder was (6.19 ±1.91)mm (range from 4 to 10mm). There were a trivial residual shunt in 2 patients by left ventriculography and the transthoracic echocardiography after the procedure. No shunt was found by the transthoracic echocardiography 1 week after the procedure. No complication occurred in all patients. Conclusion Transcatheter closure of membranous VSD with home made nitionol asymmetric two-disk occluder is safe and effective. The long-term efficacy is still to be determined by follow-up.
出处
《介入放射学杂志》
CSCD
2004年第2期101-103,共3页
Journal of Interventional Radiology
基金
上海市科技攻关项目 ( 0 14 1190 0 3 )
