应用小腰大边型封堵器治疗膜部瘤室间隔缺损  

Transcatheter closure of perimembranous ventricular septal defect with aneurysm using the thin-waist-big-side occluder

作　　者：吴婷婷[1] 任跃[1] 荣星[1] 张松跃[1] 吴蓉洲[1] 

机构地区：[1]温州医学院附属育英儿童医院儿童心血管科,浙江温州325027

出　　处：《温州医学院学报》2012年第1期32-35,共4页Journal of Wenzhou Medical College

摘　　要：目的:探讨小腰大边型封堵器在治疗膜部瘤室间隔缺损(VSD)的可行性及安全性。方法:2006年1月至2010年10月在我院行介入治疗的31例膜部瘤VSD患儿(男15例,女16例),年龄2～16(4.52±3.09)岁。在透视及超声监测下采用小腰大边型封堵器封堵膜部瘤VSD,术后即刻行左室造影、升主动脉造影及经胸超声心动图观察封堵疗效。术后24 h和1、3、6个月复查经胸超声心动图、心电图及胸部X线片。结果:所有患儿均封堵成功,技术成功率为100%,置入封堵器直径4～12(6.83±1.95)mm;封堵后15 min左室造影示即刻完全封堵28例,余2例于术后24 h、1例于术后6个月复查超声时分流消失,完全封堵率总计达100%;术后出现左前分支传导阻滞1例,24 h内恢复正常;随访6个月,所有患者均无高度房室传导阻滞、溶血、瓣膜返流、封堵器移位等严重术后并发症;介入封堵术前后经胸超声心动图各指标变化:封堵术后24 h,左心室舒张末内径、左心室舒张末容积均较术前减少(P<0.01),随访期间上述指标均进一步减少(P<0.01);左室短轴缩短率封堵术后24 h较术前减少(P<0.01),随访1个月复查时进一步减少(P<0.01),随访3、6个月时变化不明显(P>0.05);二尖瓣口流速E/A比值封堵术前后无显著变化,随访中变化亦不明显(P>0.05)。结论:应用小腰大边型封堵器治疗膜部瘤VSD安全有效,近期疗效好。Objective：To evaluate the feasibility and safety of transcatheter closure of perimembranous ventricular septal defects（PmVSD） with aneurysm using the thin-waist-big-side occluder.Methods： Thirty-one patients（15 men and 16 women） underwent transcatheter closure of PmVSD with aneurysm from January 2006 to October 2010 in our department.The mean age of patients was 4.52±3.09 years（rang from 2 to 16）.All patients were treated with the thin-waist-big-side occluders under fluoroscopy,angiography and transthoracic echocardiography（TTE）,and were followed-up at 24 hours,1 month,3 months and 6 months after the procedures.Results： The devices were implanted successfully in all patients.The mean diameter of the devices was 6.83±1.95 mm（rang from 4 to 12）.There was complete closure in 28 patients immediately.3 patients had small residual shunt but all disappeared within follow-up period.Left anterior fascicular block was found in 1 patient and recovered within 24 hours.No other complications,such as advanced atrioventricular conduction block or valve regurgitation,were found in all cases after the procedures.Conclusion： It is effective and safe to closure perimembranous ventricular septal defects（PmVSD） using the thin-waist-big-side occluder,es-pecially for those PmVSDs with aneurysm.

关 键 词：室间隔缺损 膜部瘤 小腰大边型封堵器 介入治疗 

分 类 号：R725.4[医药卫生—儿科]