干下型室间隔缺损经胸封堵术后中期随访结果  

Mid-term follow-up of perventricular device closure of subarterial ventricular septal defect

作　　者：徐铁伟 谢林[1] 赁可[1] XU Tiewei;XIE Lin;DIAN Ke(Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院心脏大血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2021年第11期1334-1339,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的对干下型室间隔缺损封堵手术的中期安全性、有效性以及可行性进行随访评估。方法回顾性分析2013年9月至2015年12月于华西医院经食管超声心动图确诊为干下型室间隔缺损97例患者的临床资料,其中男66例、女31例,中位年龄3(1.8,5.9)岁,所有患者均在全身麻醉经食管超声引导下行经胸室间隔缺损封堵术。观察术后1年、3年、5年随访期间残余分流、各瓣膜反流(如主动脉瓣反流)、房室传导阻滞及各种心律失常等情况。结果所有患者均成功实施室间隔缺损封堵手术,仅1例患者术后3个月因封堵器移位再次于体外循环下行室间隔缺损修补手术,手术成功率为99.0%。术后5年随访结果显示,所有患者均未出现残余分流、轻度以上瓣膜反流、房室传导阻滞以及各种心律失常。结论经胸室间隔缺损封堵手术治疗干下型室间隔缺损中期疗效显著,手术成功率高,具有很好的安全性和可行性。Objective To evaluate the mid-term safety, efficacy and feasibility of perventricular device closure for subarterial ventricular septal defect. Methods Clinical data of 97 patients diagnosed with subarterial ventricular septal defect through echocardiography in West China Hospital from September 2013 to December 2015 were retrospectively analyzed. There were 66 males and 31 females aged 3(1.8, 5.9) years. All the patients underwent perventricular device closure under the guidance of transesophageal echocardiography using eccentric occlusion device. Possible complications such as residual shunt, valvular regurgitation, atrioventricular conduction block and arrhythmias were recorded during the 1-year, 3-year and 5-year follow-up. Results All the patients received perventricular device closure successfully except that 1 patient underwent open surgical repair under cardiopulmonary bypass 3 months later because of the migration of device. So the rate of complete closure was 99.0%. No residual shunt, moderate or severe valvular regurgitation,atrioventricular conduction block or arrhythmias were observed 5 years later. Conclusion Treating subarterial ventricular septal defect through perventricular device closure exhibits remarkable mid-term efficacy, safety and feasibility with high success rate.

关 键 词：干下型室间隔缺损 室间隔缺损封堵术 疗效 中期随访 

分 类 号：R654.2[医药卫生—外科学]