小腰大边型封堵器堵闭膜部瘤室间隔缺损68例观察  

Clinical observation of interventional therapy of using thin-waist-big-side occluder to 68 cases of perimembranous ventricular septal defect with aneurysm

作　　者：高虹 董少红 张智伟[2] 罗林杰 石继军[2] 陈科奇 王树水[2] 李俊杰[2] 

机构地区：[1]暨南大学附属第二医院深圳市人民医院心内科,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：《暨南大学学报（自然科学与医学版）》2009年第6期668-671,680,共5页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：国家"十五"科技攻关计划项目(2001BA706B-09)

摘　　要：目的：探讨小腰大边封堵器堵闭室间隔膜部瘤缺损（PPVS）的不同部位的疗效及并发症。方法：对68例室间隔缺损（VSD）伴膜部瘤患者进行小腰大边封堵器介入治疗，术中左室造影，根据瘤体形态分为4种类型，选择4—14mm封堵器选择不同部位进行封堵。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例采用细腰大边封堵器进行封堵室间隔缺损（VSD）的患儿中，62例成功（91%）。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。9例传导阻滞患者心电图3个月内均恢复正常。结论：小腰大边封堵PPVS是安全和可行的方法，并发症少，但需正确判断膜部瘤的大小、形态、位置及瓣膜功能。Aim：There are some limitations on closure of perimembranous ventricular septal defect with pseudoaneurysm （PPVS） with symmetrical and non-decenter type occluders. This study try to evaluate the effectiveness and complications of interventional therapy using A4B2 （thin-waist-big-side type） occluder to PPVS. Methods： The ventricular septal defects with aneurysems were classified into four types and measured by left ventriculography. The diameter of the occluders ranged from 4 to 14 mm. TIE, chest X-ray film and electrocardiogram （ECG） were performed 1,3,6 and 12 months later to evaluate the efficacy. Results： Among the 68 patients, transcatheter closures were successfully conducted to 62 patients, the success rate was 91%. Residual shunt was found by transthroacic echocardiograohy （TIE） in 8 patients 24 hours later and disappeared in 12 months. Transient block in 9 patients disap- peared 3 months later. Conclusion： Interventional therapy with A4B2 occluder to perimembranous yen-tricular septal defect with pseudoaneurysm is safe, effective and promising, and has fewer complications. The key point is to select the suitable positions and right oecluder, according to the size, position, morphologie characters and valve function.

关 键 词：室间隔缺损 膜部瘤 介入治疗 堵闭器 

分 类 号：R541[医药卫生—心血管疾病]