经导管介入封堵治疗瓦氏窦瘤破裂的疗效评价  

Evaluation of the curative effect of transcatheter closure on rupture of valsalva aneurysm

作　　者：刘静 刘琦森 秦超师 段赟 尚福军 柳荫 牛晓琳 LIU Jing;LIU Qi-sen;QIN Chao-shi;DUAN Yun;SHANG Fu-jun;LIU Yin;NIU Xiao-lin(Department of Cardiology,Second Affiliated Hospital,Air Force Medical University,Xi’an 710038,Shaanxi,China;Department of Cardiology,Xi’an Chang’an District Hospital,Xi’an 710118,Shaanxi,China)

机构地区：[1]空军军医大学第二附属医院心血管内科,陕西西安710038 [2]西安市长安区医院心血管内科,陕西西安710118

出　　处：《心脏杂志》2021年第2期173-177,共5页Chinese Heart Journal

基　　金：国家自然科学基金项目资助(81570227)。

摘　　要：目的评价经导管介入封堵瓦氏窦瘤破裂的安全性和有效性。方法收集空军军医大学第二附属医院心血管内科2013年4月~2020年7月诊断为瓦氏窦瘤破裂并进行介入封堵治疗的27例患者。术后观察患者封堵器位置、有无残余漏、并发症等指标,比较术前术后患者的心功能、心脏杂音、心率、血压、心腔大小等指标的变化。结果封堵术后心脏超声证实所有患者心功能明显改善:术后24 h心率较术前明显降低(P<0.05);术后舒张压较术前明显升高(P<0.05)。术后72 h复查心脏超声确定右房内径较术前减小(P<0.05)。术后1年心脏超声发现右房内径、右室内径、左房内径、左室收缩期及舒张期内径较术前减小(P<0.05)。术后无封堵器脱落、感染性心内膜炎、血栓栓塞、溶血、残余漏、主动脉瓣反流等情况发生,随访期间也无上述状况出现。结论对于符合适应症的患者,经导管介入封堵瓦氏窦瘤破裂是一种安全有效的方法。AIM To evaluate the safety and effectiveness of transcatheter closure of ruptured sinus of valsalva aneurysm.METHODS Twenty-seven patients with ruptured sinus of valsalva aneurysm were collected from the Department of Cardiology,the Second Affiliated Hospital of the Air Force Medical University from April 2013 to July 2020.The position of the occluder,residual leakage,complications and other information of the patients after interventional therapy were collected and observed,and the patients’cardiac functions,cardiac murmur,heart rate,blood pressure,cardiac cavity size and other indicators before and after interventional therapy were compared.RESULTS Echocardiography showed that 27 patients received successful closure,24 patients had no residual leakage and 3 patients had minimal residual leakage.No serious complications occurred.One case had fever and 1 case had decreased platelet,which were cured or alleviated before discharge.Postoperative cardiac functions were significantly improved after interventional therapy.Auscultation murmurs disappeared in 26 patients and 1 patient had grade 3/6 systolic murmurs in the 3rd intercostal margin of the left sternum.Heart rate after operation was significantly lower than that before operation(P<0.05).There was no significant difference in blood pressure before and after operation.Echocardiography at 72 nh after surgery showed that the diameter of the right atrial was reduced compared with that before interventional therapy(P<0.05).Echocardiography one year after operation showed that the diameters of the right chamber,right ventricle,left atrium,and the systolic and diastolic diameter of the left ventricle were decreased compared with those before surgery(P<0.05).CONCLUSION Transcatheter closure is a safe and effective method for ruptured sinus of valsalva aneurysm in patients with suitable indications.

关 键 词：瓦氏窦瘤破裂 经导管封堵 封堵器 

分 类 号：R543.1[医药卫生—心血管疾病]