国产封堵器治疗膜部室间隔缺损  

Catheter closure of membranous septal defects using domestic membranous ventricular septal defect occluder

作　　者：潘明[1] 邓爱云[1] 白明[1] 李强[1] 张钲[1] 黄晏[1] 药素毓[1] 王世杰[1] 马春香[1] 

机构地区：[1]兰州大学第一医院心内科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2007年第4期65-67,共3页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的应用国产封堵器介入治疗膜部室间隔缺损(MVSD)并评价其疗效。方法应用国产封堵器介入治疗60例MVSD患者,手术中连续经胸超声心动图或和X线监测。术后随访3个月。结果60例患者应用国产封堵器介入治疗MVSD,其中男41例,女19例。超声心动图测定MVSD直径为3～9.4 mm,左心室造影测定MVSD直径为3～9.4 mm,所选国产MVSD封堵器直径为4～12 mm。封堵操作技术成功率为100%。超声心动图示术后即刻残余分流为10.5%,3个月后残余分流为5.7%。手术中出现一过性房性心动过速、室性心动过速、房室传导阻滞及束支传导阻滞均恢复。术后3例患者出现右束支传导阻滞,1例出现左柬支传导阻滞,随访3个月,2例右束支传导阻滞恢复正常,无主动脉瓣关闭不全、三尖瓣关闭不全、封堵器移位或破损及感染性心内膜炎等发生。结论室间隔缺损封堵术作为治疗室间隔缺损的新方法,即时的疗效确切。采用封堵术治疗室间隔缺损应遵循治疗原则,术中遵守操作规范,术后严密观察,从而减少并发症的发生。Objective To evaluate the effectiveness and safety of transcatheter closure of membranous ventrieular septal defect （MVSD） using home made ventricular septal defect occluder, Methods Patients with echocadiography ultrasonic cadiography confirmed MVSD underwent transcatheter closure with domestic MVSD occluder, Transthorac echocardiography and X-ray were used continuously to monitor the procedure, Transthorac echocardiography was performed immediately after the release of devices, and 3 months after the procedure. Results The mean diameter of MVSD measured by echocardiography or angiography was 3～9.4 mm. The mean size of the occluder was 4～12 mm. The successful rate of device implantation was 100%. The residual shunt immediately after the closure was 10,5%. After 3 months＇ follow-up, only 5,7% trivial residual shunt existed. No death occurred during and after the procedure, Atrial tachycardia, ventricular tachycardia and bundle （right and left bundle） branch block, considered to be related to catheter manipulation inside the chamber of ventricle, were common and transient, Three patients developed right bundle branch block 24 h after the procedure, and 1 patient developed left bundle branch block, After 3 months＇ follow-up, 2 patients recovered. No aortic regurgitation and tricuspid insufficiency occurred during and after the procedure. No displacement or rupture of devices and endocarditis happened. Conclusions Transcatheter occlusion shows a promising therapeutic effect on ventricular septal defect. To prevent complications, therapeutic rules and technical criteria should be obeyed and close monitoring after the closure should be carried out.

关 键 词：膜部室间隔缺损 封堵器 心导管术 

分 类 号：R541[医药卫生—心血管疾病]