超声引导下经右颈内静脉可调弯鞘行房间隔缺损封堵术的临床应用  

Percutaneous trans-jugular vein closure of atrial septal defect with steerable introducer under echocardiographic guidance

作　　者：杨超[1] 廖胜杰 方剑[2] 马伦超[1] 陆国梁[1] 张英元[1] 黄杰周[1] 谢少波[1] YANG Chao LIAO Shengjie FANG Jian MA Lunchao LU Guoliang ZHANG Yingyuan HUANG Jiezhou XIE Shaobo(Department of Cardiothoracic Surgery Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China)

机构地区：[1]广州医科大学附属第一医院心脏外科,广东5101202 [2]广州医科大学附属第一医院麻醉科

出　　处：《临床心血管病杂志》2016年第12期1201-1203,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨一种全新的超声引导下经右颈内静脉可调弯鞘的房间隔缺损(ASD)封堵手术方式。方法:共15例ASD患者经颈内静脉穿刺,送入可调弯鞘,超声引导下调节鞘管头端,使其与房间隔平面垂直并居于ASD正中,选择适当大小的封堵器通过鞘管,常规释放左盘伞及右盘伞。结果:所有患者均封堵成功,手术时间(27.4±5.6)min,心内操作时间(6.7±5.2)min,全部病例无残余分流,住院期间无死亡,无心律失常、溶血及心内感染,无颈内静脉损伤及栓塞。术后随访1个月,所有患者无残余分流,无封堵器脱落、移位等并发症。结论:超声引导下经右颈内静脉可调弯鞘ASD封堵术是一种操作简单,创伤轻微,适应证更广,并发症更小的新术式,较传统的经皮介入封堵、经胸封堵有明显优势。Objective： To discuss a novel surgical approach of percutaneous trans-jugular vein closure of atrial septal defect（ASD）with steerable introducer under echocardiographic guidance.Method：Fifteen ASD patients underwent percutaneous trans-jugular vein ASD closure,the occluder was placed in direction perpendicular to the plane of ASD using the steerable introducer.Result：All cases succeeded.The average procedure time was（27.4±5.6）minutes;and the average intracardiac operation time was（6.7±5.2）minutes.No patient showed residual shunt after the procedure.There was no clinical death,no arrhythmia,no hemolysis,no infection,no jugular vein damage or occlusion during patients＇ hospitalization.The post-operation follow up after one month of the operation showed that there was no residual shunt,no falling off or detachment of occluders or other complications.Conclusion：It is a new surgical method with easy operation,mild damage and wider indication.Compared with the traditional percutaneous and transthoracic closure of ASD,it has obvious advantages.

关 键 词：超声引导 颈内静脉 房间隔缺损 

分 类 号：R541.1[医药卫生—心血管疾病]