Amplatzer房间隔缺损封堵器置入体内后形态的变化  

The shape changes of Amplatzer septal occluder after transcatheter implantations

作　　者：张戈军[1] 戴汝平[1] 徐仲英[1] 蒋世良[1] 黄连军[1] 杨振文[1] 刘延玲[2] 吕秀章[2] 朱振辉[2] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院放射科,北京100037 [2]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院超声科,北京100037

出　　处：《中国介入心脏病学杂志》2003年第4期194-196,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的　探讨Amplatzer房间隔缺损封堵器 (ASO)置入人体后形态的变化及其可能的影响。方法　全组共 34例房间隔缺损患者 ,按常规方法置入ASO ,于术后 2 4～ 4 8h、3个月及 1年以计算机X线摄影系统 (CR)进行X线平片检查。选择左侧位片 ,以CR自带测量系统测量封堵器左、右房盘状结构中心的不透X线的金属标记的间距 (D1)、封堵器左、右房盘状结构的直径 (D2、D3)。同时 ,患者亦行经胸超声心动图 (TTE)检查 ,以评价封堵效果及封堵器对毗邻结构的影响。结果　 34例封堵器置入均获得成功。本组病例ASD直径为 (2 0 0 9± 6 0 0 )mm(6～ 2 9mm) ,选择的封堵器直径为(2 3 97± 5 93)mm(10～ 34mm)。 34例均完成了术后 2 4～ 4 8h及术后 3个月的随访 ,10例完成了术后1年的随访。术后 3个月D1较术后 2 4～ 4 8h缩小 ,提示封堵器厚度变薄 ,D2及D3则无明显改变 ;术后 1年D1较术后 3个月进一步缩小 ,提示封堵器厚度继续减小 ,而D2及D3未见显著改变。D1与封堵器的直径呈部分相关。随访中TTE示ASD均完全闭合 ,未见残余分流 ;ASD毗邻结构未见受到封堵器形态变化的影响。结论　应用X线平片及TTE可对Amplatzer房间隔缺损封堵器置入体内后的形态进行无创性观察。封堵器的厚度与其直径部分相关 ,在随访中厚度逐渐减小 ,几何?Objective To evaluate the shape changes of Amplatzer Septal Occluder (ASO) after transcatheter closure of Atrial Septal Defect (ASD). Methods There were 34 patients at the age of 30.56±14.37 years (ranging from 5 to 55 years) and with the weights of 56.10±14.64 kg (ranging from 18 to 82 kg). All ASDs were occluded with ASO. Every patient underwent X-ray plain film examination with Fuji Computed Radiography (CR) system 24-48 hours, 3 months and 1 year after the transcatheter closure procedures. Three parameters were measured on the lateral view film with CR system to evaluate the ASO′s shapes: (a) the distance (D1) between two masks on the left and right atrial disks; (2) the diameter (D2) of left atrial disk; and (3) the diameter (D3) of right atrial disk. At the same time, every patient underwent transthoracic echocardiographic examination to evaluate influences of ASO shape changes. Results ASOs were placed and ASDs were occluded successfully in all the 34 patients. The diameters of ASDs ranged from 6 to 29 mm, and the diameters of ASOs from 10 to 34 mm. All the patients completed the follow-up 24-48 hours and 3 months after the procedures. Ten patients completed the follow-up 1 year after the procedures. D1 was lesser 3 months after the procedures than 24-48 hours after the procedures, and decreased further 1 year after the procedure. These findings suggested the thickness of ASO decreased in the follow-up. Meanwhile, D1 and D2 didn′t change significantly during the follow-up. The thickness of ASO was partially related to the diameter of the device. TTE found that the changes of ASO′s shapes didn′t influence the structures near ASO. Conclusion The shape changes of ASO after implantation could be observed non-invasively with X-ray plain film and TTE during the follow-up. The thickness of device was partially related to the diameter of the device, and decreased during the follow-up, so that the device could get a better profile. The shape changes of ASO didn′t affect its efficiency.

关 键 词：AMPLATZER封堵器 房间隔缺损 置入术 X线平片检查 介入治疗 

分 类 号：R654.2[医药卫生—外科学]