继发孔型房间隔缺损介入性封堵术27例临床报告  

Clinical report on transcatheter closure of atrial septal defects in 27 patients

作　　者：邓东安[1] 侯传举[1] 韩秀敏[1] 盛小棠 陈淑娴[1] 唐敏[1] 张玉威[1] 邓亚安[2] 

机构地区：[1]沈阳军区总医院心血管研究所,110015 [2]沈阳军区第一疗养院

出　　处：《中华心血管病杂志》2000年第2期99-101,共3页Chinese Journal of Cardiology

摘　　要：目的　评价应用AGAAmplatzer闭合器对非开胸手术闭合继发孔型房间隔缺损 (atrialseptaldefect,ASD)的疗效。方法　 2 7例ASD住院患者 ,男 7例 ,女 2 0例。年龄 3～ 49岁 ,平均 31 9岁。体重 18～ 88kg,平均 5 8 2kg。ASD病理分型 :中央型 2 4例 ,中央偏上型 2例 ,下腔型 1例。其中单一ASD 2 5例 ,多发性ASD 2例 (2处缺损 1例 ,3处缺损 1例 ) ,合并肺动脉瓣狭窄 (PS)和合并房间隔膨出瘤各 1例。ASD直径 1 0～ 3 6cm(球囊伸长直径 )。应用AGAAmplatzer闭合器闭合ASD ,经静脉用 7～ 12F的长鞘在X线和超声监视下将闭合器导入 ,其闭合器大小与球囊伸长直径相等或小于 1mm。其中 1例合并PS同时行肺动脉瓣球囊扩张术。结果　 2 7例ASD患者应用 2 6个Amplatzer闭合器闭合成功 ,1例因ASD直径 3 5cm闭合器传入 5次未成功 ,成功率为 96 %。 2 6例无并发症 ,1例出现“脑栓塞”并发症 ,经积极治疗 ,15天治愈出院。 2 7例患者均无残余分流。结论　AGAAmplatzer闭合器闭合ASD是安全的、有效的。Objective To evaluate the safety and efficiency of transcatheter closure of secundum atrial septal defect (ASD) with Amplatzer occlusion device. Methods Twenty seven patients of ASD, 7 males, 20 females, with a mean age 27.5 (ranged from 3 to 49) years, mean weight 58 (ranged from 18 to 88) kg were studied. The pathologic classification of ASD: 24 were central type, 2 were super central type, 1 was inferior cava type. Of 27 patients, 25 were single defect, 2 were multiple, with one of two defects, another of three defects; 1 was complicated with pulmonary stenosis (PS), 1 with interatrial septal aneurysm. The diameter of ASD (balloon stretched diameter) was 1 0-3 6 cm. 26 patients underwent the proceduce with Amplatzer occlusion device. The device was advanced to ASD with a 7-12F long guiding sheath and deployed under fluoroscopic and ultrasound guidance. The Amplatzer occluder size was chosen to be equal to or 1 mm more than the streched diameter of ASD. Results Of 27 patients, 26 had successful implantation of the Amplatzer device, one was not. Successful modulus was 96%. No complications were observed in 26 except one with cerebral embolism after deployment of the prothesis, who was actively treated and recovered in 15 days. No residual shunt was found in all patients. Conclusion The Amplatzer is an efficient prosthesis that can be safely applied in patients with ASD.

关 键 词：房间隔缺损 心脏导管插入术 AMPLATZER 封堵器 

分 类 号：R541[医药卫生—心血管疾病]