经导管封堵治疗膜部瘤型室间隔缺损的初步临床分析

目的探讨应用国产封堵器经导管封堵合并膜部瘤型室间隔缺损(ventricularseptaldefect,VSD)的临床疗效。方法共12例膜周部VSD合并膜部瘤形成患者,男5例,女7例,平均年龄16.4±10.7岁(3—45岁)。采用国产对称型室间隔缺损封堵器在透视及超声监测下进行VSD封堵术,术后即刻行左室造影、升主动脉造影及经胸超声心动图(TTE)检查验证即刻疗效,术后24小时、1个月、3个月、6个月、12个月行心电图、TTE、X线胸片随访复查。结果 11例患者封堵成功,技术成功率91.6%(11/12),其中包括漏斗状膜部瘤5例,菜花状膜部瘤3例,囊袋状膜部瘤3例。1例囊袋状膜部瘤患者因封堵后仍有直径3mm的中量残余分流,放弃封堵。11例患者中7例术后即刻达到完全封堵;4例术后即刻造影及TTE检查显示少量残余分流,24h后超声检查证实残余分流消失3例,另1例1个月复查时残余分流消失,总完全封堵率达100%。1例患者术后新出现完全右束支传导阻滞,1例患者术后24h出现交界性逸博心律,2天后恢复正常,余无其他严重并发症发生。11例患者平均随访10.2±5.2个月(3~18个月),无封堵器移位、晚发心律失常等并发症发生。结论应用国产封堵器对合并膜部瘤型膜周部室间隔缺损进行介入封堵治疗是可行的,近期临床效果满意。

The Clinical Efficacy of Transcatheter Closure of Ventricular Septal Defect With Aneurysm Using Home-made Occlusion Devices

Objective To evaluate the clinical effi cacy of transcatheter closure of ventricular septal defect with aneurysm using home-made occlusion device. Methods Eleven patients were included, among whom 5 were male and 7 were female （age from 3 to 45years） . All patients were monitored by ？ uoroscope and transthoracic echocardiography （ TTE ） during the procedure . All patients were reexamined by TTE , ECG and X-ray after 24hours , 1 month , 3 months , 6 months ,12 months respectively . Results The occluder was successfully placed in 11 cases. Angiography and TTE showed immediate closure in 7 patients ,and mild residual shunt was found in 4 patients and disappear during one month by TTE examination . There were no severe complications . Conclusion Transcatheter closure of VSD with aneurysm using home-made occlusion device is safe and effective.