Amplatzer封堵器治疗房间隔缺损的方法学研究和临床疗效评价  

The Methodological Study and Clinical Evaluation of Amplatzer Septal Occluder Device in Atrial Septal Defect

作　　者：吴兵[1] 江洪[1] 郭瑞强[2] 王小红[1] 漆曙辉[1] 刘华芬[1] 

机构地区：[1]武汉大学人民医院心内科,湖北武汉430060 [2]武汉大学人民医院超声科,湖北武汉430060

出　　处：《生物医学工程与临床》2004年第1期17-19,F002,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的　采用数字影像测量球囊直径指导Amplatzer封堵器植入 ,评价这一方法的可靠性及近期临床疗效。 方法　 30例病人 ,经胸壁超声心动图 (TTE)检查证实为先天性心脏病房间隔缺损 (ASD)。在X线透视及经食管超声心动图监视下 ,采用数字影像测量球囊直径指导选用适宜直径的Amplatzer封堵器封堵ASD。术后 3天、3个月及 1年分别行经胸超声心动图 (TTE)、心电图及X线检查评价治疗效果。结果　 30例ASD术中TEE测定直径、球囊伸展直径和封堵器直径分别为 10 30mm [(2 0 .3± 5 .0 )mm]、10 34mm[(2 1.8± 6 .1)mm]和 12 38mm [(2 4 .8± 6 .4 )mm]。 30枚封堵器植入均获得成功 ,一次封堵成功率 85 %。 30例均完成 3个月随访 ,TTE显示ASD完全闭合 ,右心房、心室缩小 ;其中 2 0例完成术后 1年随访 ,未见残余分流及再通。Objective To evaluate the reliability and clinical effect of Amplatzer septal occluder device in atrial septal defect guiding by digital imaging balloon diameter measuring. Methods Thirty patients definitely diagnosed congenital atrial septal defect by transthoracic echo cardiogram(TTE) were occluded by optimate diameter Amplatzer septal occluder guiding with di gital imaging measuring the balloon diameter. The therapeutic effects of these patients were evaluated by TTE, ECG and Xray examination in 3 days, 3 months and 1 year postoperatively. Results Of the 30 patients the transesophageal echo cardiogram(TEE) measured sepatal defect diameter, balloon stretching diameter and the occluder stretching diameter were 10~30 mm[(20.3±5.0) mm], 10~34 mm[(21.8±6.1) mm] and 12～38 mm[(24.8±6.4) mm] respectively. The septal defects of these 30 patients were successfully closed by ASD. The successful rate of first implantation with ASD for closure of septal defect was 85 %. Three months following up had been completed in all of the 30 pateints, any residual shunt was not found by TTE and both pulmonary vascularity and heart size were improved . Twenty patients were carried out 1 year follow up and no residual shunt and recanalization were found.Conclusion Adopting digital image balloon diameter measure system for guiding transcatheter closure of atrial septal defect with Amplatzer septal occluder device is a simple and reliable approach.

关 键 词：房间隔缺损 AMPLATZER封堵器 介入治疗 植入治疗 

分 类 号：R541.1[医药卫生—心血管疾病]