心腔内超声指导下的柔腰单铆型卵圆孔未闭封堵器植入实验研究  

Experimental study of flexible lumbar single riveting patent foramen ovale occluder implantation under the guidance of intracardiac ultrasound

作　　者：李小龙 刘超 游仲帅 张康丽 黄松群 郭志福 LI Xiao-long;LIU Chao;YOU Zhong-shuai;ZHANG Kang-li;HUANG Song-qun;GUO Zhi-fu(Department of Cardiovasology,Changhai Hospital,Naval Medical University,Shanghai 200433,China;Department of internal medicine,Hospital of No.73146 Troops of PLA,Quanzhou 362321,China)

机构地区：[1]海军军医大学第一附属医院心血管内科,上海市200433 [2]中国人民解放军第73146部队医院内科

出　　处：《中国心血管病研究》2024年第2期178-184,共7页Chinese Journal of Cardiovascular Research

基　　金：上海市“医苑新星”杰出青年人才计划(20224Z0007)。

摘　　要：目的评价新型柔腰单铆型卵圆孔未闭(PFO)封堵器在心腔内超声(intracardiac echocardiography,ICE)指导下行卵圆孔未闭封堵术的可行性、安全性和有效性,为临床研究提供实验依据和操作指导。方法2023年2月至2023年10月期间于长海医院临床研究中心选取10只健康成年犬,在ICE指导下行卵圆孔未闭建立PFO模型并行柔腰单铆型PFO封堵器植入,术后即刻、1个月、3个月、6个月分别通过心脏大体标本、光镜、电镜检查,评价柔腰单铆型卵圆孔未闭封堵器植入后的内皮化过程,观察有无残余分流、血栓形成等并发症。结果10只犬在ICE指导下均成功完成PFO模型建模并成功植入柔腰单铆型PFO封堵器,造模成功率100%,封堵器植入成功率100%,术中无并发症发生,所有实验犬均达到随访终点。10只犬术后即刻、1个月、3个月、6个月分别取出心脏大体标本进行观察,结果显示10只犬封堵器均无移位、合金丝断裂、血栓附着和赘生物,光镜和电镜检查显示封堵器在3月组、6月组内皮化良好。结论新型柔腰单铆型PFO封堵器设计科学,用于犬PFO封堵可行、安全、有效,ICE指导的房间隔穿刺术和PFO封堵术直观、安全、高效。Objective To evaluate the feasibility,safety and efficacy of the new soft-waisted single riveting patent foramen ovale(PFO)occluder guided by intracardiac echocardiography(ICE).Methods From February 2023 to October 2023,10 healthy adult dogs were selected from the Clinical Research Center of Changhai Hospital,and a PFO model was established under ICE guidance.The endothelialization process after implantation of the occluder was evaluated by the cardiac gross specimens,light microscopy and electron microscopy immediately,1 month,3 months and 6 months after the surgery,and the complications such as residual shunt and thrombosis were observed meanwhile.Results All 10 dogs successfully completed the PFO model modeling and were implanted the soft-waisted single-riveting PFO occluder under the guidance of ICE,with a molding success rate of 100% and a 100% success rate of occluder implantation,but no complications occurred during the operation;all the experimental dogs reached the follow-up endpoint.The gross cardiac specimens of 10 dogs were taken out immediately,1-month group,3-month group and 6-month group after surgery for observation and the results showed that there was no displacement,alloy wire breakage,thrombus attachment and vegetations;and light microscopy and electron microscopy showed that the occluder completed endothelial coverage in the 3-month group and 6-month group.Conclusion The novel flexible waist single riveting PFO occluder is scientifically designed.It is feasible,safe and effective for canine PFO occlureation;and the ICE-guided atrial septal puncture and PFO occluder are intuitive,safe and efficient.

关 键 词：卵圆孔未闭 心腔内超声 房间隔穿刺 残余分流 内皮化 封堵器 动物实验 

分 类 号：Q95-33[生物学—动物学] R541.7[医药卫生—心血管疾病]