选择成人巨大房间隔缺损介入治疗封堵器的影响因素  

Impact factors of occluder choice for transcatheter closure of adult large atrialseptal defect

作　　者：和旭梅[1] 谢学刚 何璐[1] 王星烨[1] 杜亚娟[1] 张玉顺[1] HE Xumei;XIE Xuegang;HE Lu;WANG Xingye;DU Yajuan;ZHANG Yushun(Department of Structural Heart Disease,the First Affiliated Hospital,Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院结构性心脏病科

出　　处：《中国介入影像与治疗学》2019年第12期717-720,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的分析选择成人巨大房间隔缺损(ASD)介入治疗封堵器的影响因素。方法回顾性分析65例接受介入治疗的巨大ASD患者,分析封堵器选择与缺损直径、缺损形态及缺损边缘状况的关系。结果 65例均封堵成功。26例采用直径为40 mm封堵器、24例42 mm、15例≥44 mm,三者间缺损最大直径、最小直径及二者比值、封堵器加大值差异均无统计学意义(P均>0.05)。缺损最小直径/缺损最大直径<0.80(n=24)与≥0.80(n=41)二者之间缺损最大直径、最小直径及封堵器加大值差异均有统计学意义(P均<0.05),缺损主动脉缘或后下缘<5 mm(n=45)与≥5 mm(n=20)二者之间封堵器直径、封堵器加大值差异有统计学意义(P均<0.05)。结论介入治疗成人巨大ASD时,缺损直径、缺损形态及其边缘情况均影响封堵器选择。Objective To analyze the impact factors of occluder choice for transcatheter closure of adult large atrial septal defect(ASD). Methods Data of 65 patients with large ASD were retrospectively analyzed. The relationships of occluder choice for transcatheter closure of ASD and the diameter, shape and edge of defect were observed. Results ASD in all patients were successfully occluded, with 40 mm diameter occluders in 26 cases, 42 mm diameter occluders in 24 cases and ≥ 44 mm diameter occluders in 15 cases. There was no difference of defect maximum diameter(Dmax), minimum diameter(Dmin), Dmin/Dmaxnor the added value of occluder(all P>0.05) among the above three, whereas there were statistical differences of Dmax, Dmin and the added value of Dmin/Dmax<0.80(n=24) and ≥0.80(n=41) occluders(all P<0.05). Meanwhile, significant differences of diameter and the added value of occluders were noticed between patients with distance of defect aortic margin or posterior inferior margin <5 mm(n=45) and those ≥5 mm(n=20, all P<0.05). Conclusion For intervention treatment of adult large ASD, the diameter, shape and edge of defect are the impact factors of choice of occluder.

关 键 词：房间隔缺损 介入治疗 超声检查 

分 类 号：R541.1[医药卫生—心血管疾病] R445.1[医药卫生—内科学]