Amplatzer房间隔封堵器治疗200例的并发症  

Complications of consecutive 200 cases with Amplatzer atrial defect occluder

作　　者：李寰[1] 张玉顺[1] 吴栋梁[1] 贾国良[1] 代政学[1] 何争[1] 王小燕[1] 

机构地区：[1]第四军医大学西京医院心血管内科,陕西西安710032

出　　处：《心脏杂志》2003年第6期549-551,共3页Chinese Heart Journal

摘　　要：目的 :总结我院连续 2 0 0例房间隔缺损采用 Amplatzer封堵器治疗的并发症。方法 :接受治疗的患者 2 0 0 (男68,女 13 2 )例 ,年龄 2 6± 16(1.0～ 67)岁 ,均经症状、体征、X线、ECG、B超等确诊为房间隔缺损 ,并发肺动脉瓣狭窄5例 ,二尖瓣狭窄 2例 ,动脉导管未闭 2例 ,多孔房间隔缺损 10例。所有患者在我院行 Amplatzer房间隔缺损封堵治疗 ,同时观察术中、术后出现的并发症。结果 :房间隔缺损大小为 2 0± 8(2 .5～ 3 7) mm,植入的封堵器大小为 2 6±9(5～ 40 ) mm,共植入 Amplatzer房间隔封堵器 2 0 3个 ,技术成功率 99.5% ,同时植入 2个封堵器的患者共 4例。严重并发症发生率为 2 % (4例 ) ,1例术后心包填塞急诊转到心脏外科手术 ;1例术后 2 d出现不明原因的脑出血 ;1例术中导管断裂 ,急诊转心脏外科手术取出断裂导管并行修补术 ;1例术后 3月、6月出现封堵器内少至中量分流。其他并发症有术中出现 ST段弓背向上抬高 8例 ,暂时性 度 型及 度 型房室传导阻滞各 2例 ,术后发生房颤4例。结论 :Amplatzer封堵器治疗房间隔缺损严重并发症发生率低 ,作者认为是一种安全。AIM: To review the complications of consecutive 200 cases of atrial septal defects having received treatment of Amplatz er atrial defect occluder in our hospital. METHODS: Consecutive 200 pa tients (68 male, 132 female) aged 26±16 (ranging from 1.0 to 67 years old ) wer e diagnosed as atrial septal defects by symptoms, physical signs, X-rays, ECG a nd ultrasounds. Among them 5 combined with pulmonary arterial valve stenosis, 2 with mitral valve stenosis, 2 with patent ductus arteriosus and 10 having m ultiple pores. All patients were treated with Amplatzer atrial septal defect occ lude rs in our hospital and the complications were reviewed. RESULTS: The s ize of atrial septal defect was 20±8(from 2.5 to 37)mm. The implanting occluder was 26±9 ( from 5 to 40) mm. The total of 203 Amplatzer occluders had been implanted. The t echnique succ ess rate was 99.5%. Four patients had 2 occluders implanted at the same time. Th e incidence of serious complication was 2%. Pericardial tampon ade after the procedure occurred in one patient,who was in no time undergo cardi ac surgery. One patient got uncertain cerebral hemorrhage after 2 days of occlu der implant. Catheter broken in one patient during the procedure and the patient received emergen cy cardiac surgery. One case was found small to medium shunt throug h the occluder after 3 and 6 months of the occlusion. Other complications includ ing ST elegated during the procedurein in 8 cases, temporary Ⅱ°Ⅰat rial vent ricular blockin in 2 cases and Ⅱ°Ⅱ atrial ventricular block in 2 cases. Atria l fibrillation occurred in 4 patients after occlusion. CONCLUSION: The inc idence of serious complication of Amplatzer atrial septal defect occluder is ver y low,which suggests that transcatheter occlusion of atrial septal defect with Amplatzer is a safe and effective method.

关 键 词：AMPLATZER封堵器 房间隔缺损 并发症 急性心包填塞 心电图 

分 类 号：R654.2[医药卫生—外科学]