应用Amplatzer封堵器治疗多孔的房间隔缺损及其初步疗效评价  

Transcatheter closure of multiple secundum atrial septal defects using Amplatzer septal occluder:a preliminary result of clinical appli cation

作　　者：陈关良[1] 李新明[1] 王卫[1] 李斌[1] 王圣[1] 杨炳昂[1] 王青[1] 黄雪茹[1] 赵军[1] 

机构地区：[1]海南省人民医院心内科,海南海口570311

出　　处：《海南医学》2005年第1期1-2,共2页Hainan Medical Journal

摘　　要：目的应用Amplatzer封堵器治疗多孔的继发孔型房间隔缺损(ASD),并对其疗效进行初步评价。方法7例多孔ASD病人,男性3例,女性4例,年龄12-36岁(16.6±7.3)岁,体重38-65(40.1±9.5kg)。所有病例均于X线透视和术中超声心动图监测下置入一个Amplatzer封堵器同时闭合大小缺损。术后重复TTE、ECG及X线平片检查以评价疗效。结果7例患者封堵器置入均获成功。除1例术中发生短暂性ST段抬高外,无其他严重并发症。早期3例根据球囊测量值选择封堵器,余4例根据TTE测量值选择封堵器,采用封堵器直径为18-34(24.4±7.0mm)。术后即刻TTE检查显示7例患者大缺损均获完全闭合,但有2例患者其小缺损存在微量到少量残余分流。术后24h复查提示1例仍存在少量分流。随访至3个月时分流消失。结论经导管置入Amplatzer封堵器治疗多孔的ASD是一安全有效的方法,近期疗效满意,中远期疗效尚需进一步观察。Objective To evaluate efficiency and safety of transcatheter closure of multiple secundum atrial sep-tal defect(ASD)using Amplatzer septal occluder(ASO).Methods There were7patients with multiple ASDs (3male,and4female).The mean age is16.6+7.3years(ranging froml 12to36years),and the mean weight is40.1+9.5kg(ranging from38to65kg).Guided by X ray fluoroscopy and echocardiography,one ASO was implanted to close both bigger defect and smaller one in all cases.Transthoracic echocardiography(TTE),ECG,X-ray examination were repeated after the procedures as follow-up to evaluate the safety and efficiency.Results The placement of the occluders were successful in all7patients.There were1case of transient ST segment ele-vating during operation,and there was no mortality or emergent surgery.3occluders were selected by balloon stretched diameter,and4on transthoracic echocardiography(TTE)measured diameter.The mean diameter of the occluders used was24.4+7.0mm(ranging from18to34mm).Immediately after the procedures,TTE confirmed that the bigger defects were occluded completely in all cases,but there were trivial or small residual shunts of small defects in2cases.The residual shunts were present in1cases24h after the procedure.But it disapeared after three months.Conclusions Transcatheter closure of multiple secundum ASDs using Amplatzer septal occluder is safe and efficient,and the long time follow-up remains to be.

关 键 词：房间隔缺损 心导管术 AMPLATZER封堵器 

分 类 号：R541[医药卫生—心血管疾病]