经导管介入封堵治疗左室-右房通道  

A trail of transcatheter closure of left ventricular-right atrium communication

作　　者：牟楠楠[1] 孙媛媛[1] 郑晓舟 张波 梁家立 孙浩峰 

机构地区：[1]济南军区总医院超声诊断科,250031 [2]心外科

出　　处：《中华超声影像学杂志》2013年第7期580-582,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨左室-右房通道介入封堵治疗的可行性。方法采用国产室间隔缺损封堵器经导管介入治疗左室-右房通道22例。结果封堵成功21例，1例因植入封堵器后出现主动脉瓣反流而放弃。成功的21例心前区杂音均消失，术后超声心动图检查及随访期间超声心动图检查均示原缺损部位无残余分流，主动脉瓣无反流，术前存在三尖瓣反流者术后反流明显减轻，心电图检查示无房室传导阻滞或新的束支阻滞发生。本组选用对称型封堵器18枚，A482型封堵器3枚。结论应用导管技术介入封堵治疗左室-右房通道是可行的，但须尽可能选择完全匹配的封堵器型号，以避免房室传导阻滞、主动脉瓣反流和三尖瓣反流等并发症发生。Objective To review and summarize the experiences of transcatheter closure of left ventricular-right atrium communication,and discuss the feasibility of interventional therapy for this kind of cardiac abnormalitis. Methods 22 patients who suffered from left ventricular-right atrium communication underwent transcatheter interventiona[ therapy with ventricular septal defect（VSD） occluder. The operating procedures were performed as like as the transcatheter closure of VSD： established the pathway from femoral artery to femoral vein through left ventricle,VSD,right atrium （or from left ventricle to right atrial through the communication） and inferior vena cava, then inserted the polysheath from femoral vein, introduced by the pathway to left ventricle,and implanted VSD occluder through the polysheath to close the shunt. Results The operation succeeded in 21 patients. The cardiac murmur was disappeared in all patients, and there was no residual shunt or aortic regurgitation that conformed by postoperative ventriculography and echocardiography in follow up phase, and the tricuspid regurgitation was lessened than preoperative. The operation abort in 1 patient because of aortic regurgitation after implanting oceluder. Conclusions Transcatheter closure of left ventricular-right atrium communication is feasible as the selected occluder is accordant,and atrioventricular block,aortic regurgitation and tricuspid regurgitation can be avoided.

关 键 词：超声心动描记术 心脏缺损 先天性 左室-右房通道 封堵器 

分 类 号：R654.2[医药卫生—外科学]