小腰大边型封堵器封堵膜部瘤室间隔缺损术后的中期随访评价  

Intermedium follow-up study on interventional therapy using thin waist type occluder to perimembranous ventricular septal defect with aneurysm

作　　者：高虹[1] 董少红[1] 张智伟[2] 罗林杰[1] 陈科奇[1] 

机构地区：[1]暨南大学第二临床医学院心内科,广东深圳518020 [2]广东省人民医院心血管病研究所,广东广州510100

出　　处：《中国医药导报》2009年第34期14-17,共4页China Medical Herald

摘　　要：目的:探讨小腰大边型封堵器在室间隔膜部瘤介入治疗术后的中期随访情况。方法:对68例室间隔缺损伴膜部瘤患者进行小腰大边型封堵器介入治疗,术中行左室造影,根据瘤体形态分为4种类型,选择4～14mm封堵器进行封堵。术后24h、1个月、3个月、6个月、12个月予以胸片、心电图、经胸超声心动图检查。结果:本组68例采用小腰大边型封堵器进行封堵VSD的患儿中,62例成功,成功率为94%。术后24h复查超声心动图,8例少量残余分流。术后1年复查残余分流消失。术后随访,6个月时右室流出道(RVOT)血流速度降低,心/胸比例(C/T)、肺动脉平均压(MPAP)、左室舒张末内径(LVEDD)、左室舒张末压力(LVEDP)均有下降,左室短轴缩短率(FS)升高(P<0.01)。9例传导阻滞患者心电图3个月均恢复正常。结论:小腰大边封堵PPVS是安全和可行的,并发症少,对心功能有改善作用,需要注意中、长期观察及随访。Objective： To evaluate the intermedium effectiveness of interventional therapy using A4B2 （thin waist type） occluder to perimembranous ventricular septal defect with pseudoaneurysm. Methods： The ventricular septal defects with aneurysems were classified into four types and measured by left ventriculography among 68 patients. The diameter of the occluders ranged from 4 to 14 mm. Transthroacic echocardiograohy （T-FE）, chest X-ray film and electrocardiogram （ECG） were performed 24 h, 1, 3, 6 and 12 months later. Results： Among the 68 patients, successful transcatheter closures were successfully conducted to 62 patients, the success rate was 94%. Residual shunt was found by TIE in 8 patients 24 h later, and disappeared after 1 year. The blood flow velocity of right ventricular outflow tract （RVOT）, the ratio for cardiac and thoracic size （C/T）, mean pulmonary artery pressure （MPAP）, left ventricular end-diastolic pressure （LVEDP） and left ventricular enddiastolic diameter （LVEDD） were all decreased, i^action shortening （FS） was increased, and the differences were significant 6 months later. Transient block in 9 patients was disappeared 3 months later. Conclusion： A4B2 （thin waist type） occluder for interventional therapy to perimembranous ventricular septal defect with pseudoaneurysm is safe, effective and promising, and has fewer complications. It can improve the left ventricular function. But we should give follow-up studies.

关 键 词：室间隔缺损 膜部瘤 介入治疗 封堵器 

分 类 号：R542.5[医药卫生—心血管疾病]