心外膜超声心动图引导下经胸镶嵌治疗单纯小儿肌部室间隔缺损  

Closure of muscular ventricular septal defect through a hybrid procedure under the intraoperative guidance of epicardial echocardiography in children

作　　者：卢绪宁 文平 刘宇航 刘启龙 刘大为 崔琳 朱全伟 王宁 Lu Xuning;Wen Ping;Liu Yuhang;Liu Qilong;Liu Dawei;Cui Lin;Zhu Quanwei;Wang Ning(Department of Heart Center,Children's Hospital of Dalian Medical University,Dalian 116012,China)

机构地区：[1]大连医科大学附属大连市儿童医院心脏中心,116012

出　　处：《中华小儿外科杂志》2021年第8期713-716,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的:探讨心外膜超声心动图(intraoperative epicardial echocardiography,IEE)引导下经胸镶嵌治疗小儿肌部室间隔缺损(muscular ventricular septal defect,mVSD)的安全性和有效性。方法:回顾性分析2014年1月至2019年2月行IEE引导经胸镶嵌封堵治疗单纯mVSD患儿9例的临床资料。其中,男6例,女3例;年龄(4.43±0.98)岁;体重(14.38±1.73)kg;mVSD直径(6.89±1.32)mm。全部患儿术后即刻评价封堵效果,并于术后1、3、6、12个月定期复查经胸超声心动图(transthoracic echocardiography,TTE)、心电图、尿常规。结果:9例患儿均在IEE引导下经胸镶嵌封堵成功,其中1例存在残余分流<2 mm。封堵器型号为(7.98±1.53)mm,术后1、3、6、12个月随访,封堵器无脱落及移位,无心律失常发生,残余分流患儿在术后6个月复查时残余分流消失。结论:IEE引导下经胸镶嵌治疗小儿mVSD,避免了体外循环,同时无X线损伤,无须使用造影剂,操作方便,并发症少,安全有效,疗效满意。Objective To assess the efficacy and safety of closing muscular ventricular septal defect(mVSD)through a hybrid procedure under the intraoperative guidance of epicardial echocardiograph(IEE)in children.Methods From January 2014 to February 2019,9 mVSD children were operated via a hybrid approach under IEE guidance.There were 6 boys and 3 girls with a mean age(4.43±0.98)years and a mean body weight of(14.38±1.73)kg.The average diameter of mVSD was(6.89±1.32)mm.The outcome was evaluated by IEE.Follow-ups were performed by transthoracic echocardiography(TTE),electrocardiogram and urine routine at Month 1/3/6/12 postoperatively.Results All cases were occluded successfully via a hybrid approach under IEE guidance.One case of residual shunt<2 mm resolved at Month 6 postoperatively.The average diameter of amplatzer occluder(7.98±1.53)mm.TTE,electrocardiogram and urine routine were re-examined at Month 1/3/6/12 postoperatively.There was no occurrence of residual shunt,occlude-loss or arrhythmia.Conclusions Hybrid device closure of mVSD guided by IEE is both safe and efficacious.With easier handling and fewer complications,it avoids the use of cardiopulmonary bypass,radiation and contrast agents.

关 键 词：儿童 心外膜超声 肌部室间隔缺损 镶嵌治疗 

分 类 号：R726.5[医药卫生—儿科]