Amplatzer房间隔封堵器治疗房间隔缺损  

Transcatheter Closure of Secundum Atrial Septal Defects with the Amplatzer Septal Occluder Device

作　　者：李田昌[1] 胡大一[1] 边红[1] 庞文跃[1] 彭建军[1] 卢长林[1] 

机构地区：[1]首都医科大学附属北京同仁医院心血管疾病诊疗中心,北京100730

出　　处：《中国医药导刊》2003年第3期182-184,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨Amplatzer房间隔封堵器治疗继发孔型房间隔缺损技术的有效性和可行性,评价其近期治疗效果。方法和结果:1998年9月至2002年11月采用Amplatzer房间隔封堵器治疗的44例房间隔缺损患者入选该研究。年龄(20±11)岁(1-67)yrs,体重(45.4±13.9)Kg(8-74)Kg。44例患者中TIE测得ASD直径为(18.6±7.2)mm(8-36mm),对于21例偏心性或直径大于20mm的房间隔缺损采用食道超声测得房间隔缺损直径(28±9.1)mm(13-36)mm,43/44患者中测得ASD球囊伸展直径(19.8±5.9)mm(10-34)mm,6例直径小于15mm的ASD Qp/Qs平均(1.5±0.3)(1.3-1.6),43/44患者Amplatzer装置放置成功,在我们早期临床实践中,有1例患者因为左房较小导致Amplatzer装置放置失败。置入的Amplatzer封堵器直径(22.8±6.1)mm(10-38)mm,有12例患者ASD直径大于25mm,平均手术时间(46.5±21)min(30-135)min,X线暴露时间(18±14)min(6-45)min。包括超声心动图在内的临床随访安排在术后第一天、第三天、一个月、三个月,之后每年一次。43例患者中有40例实现即刻封堵成功,3例残留少量分流,3天时复查超声心动图,43例全部实现完全封堵。在平均8个月随访期间,无心内膜炎和血栓栓塞事件发生,无封堵装置钢丝断裂情况发生,无封堵伞移位或丢失,无房室瓣功能障碍。结论:经导管?Objective: To evaluate the feasibility and short term results of transcatheter closure of secundum atrial septal defects (TCSASDs) using Amplatzer septal occluder ASO device. Methods and Results: Forty - four patients (pts) underwent an attempt at catheter closure of their ASDs at age of (20±11)(1-67)yrs and boday weight of (45.4±13.9)Kg(8-74) Kg using the ASO. The ASD diameter was (18.6±7.2)mm( 8-36mm) measured by Transthoracic echocardiography (TTE) in 44 pts, and (28±9.1) mm( 13 - 36)mm by transesophageal echocardiography (TEE) in 21 pts with eccentric or large ASD. The ASD balloon stretched diameter was (19.8±5.9)mm (10-34 mm) in 43 pts. Six pts with ASD diameter less than 15mm measured by TTE had right atrial and ventricular volume overload with a mean ±SD Qp/Qs of (l.5±0.3)(1.3-1.6). The device was placed correctly in 43/44 pts. Procedure failed in 1 patient withrelative small left atrium in our early experience. ASO diameter was (22.8±6. l)mm(10-38mm) . There were 12 cases with ASD diameter larger than 25mm. The fluoroscopy time was (18±14)min (6-45 min), and the procedure time was (46.5±2l) min (30-135 min). Clinical follow - up was performed on 1 day, 3day, 1 months (mo), 3mo, and yearly thereafter including TTE. At the end of the procedure, 40/43 pts achieved immediate and complete closure of the ASD and 3 pts had trivial residual shunt. ASDs were closed completely at 3th day. At a median follow - up interval of 8 mo, there have been no episodes of endocarditis, thromboembolism, or device wire fracture. There was no closure device movement and lost found in all pts. There was no atrium - ventricular valve malfunction.Conclusion: TCSASDs using the new ASO device is safe and effective in complete closure of secundum ASDs up to a diameter of 36 mm in the majority of patients with secundum atrial septal defects, which had a very high technical success rate and satisfactory short term and follow - up results.

关 键 词：AMPLATZER房间隔封堵器 治疗 继发孔型房间隔缺损 有效性 

分 类 号：R541.1[医药卫生—心血管疾病]