先天性心脏病介入治疗相关并发症分析

目的 探讨先天性心脏病经导管介入治疗的并发症及其防治方法.方法 回顾性分析本院心脏中心诊断为房间隔缺损(ASD)、室间隔缺损(VSD)和动脉导管未闭(PDA)的患者337例,其中成功行经导管介入治疗的325例患者术中和术后并发症;通过心电图和心脏超声观察术中和术后出现的并发症,出院后门诊随访心电图和心脏超声6个月至1年.结果 337例患者中325例成功行先天性心脏病介入治疗,总成功率96.4%,ASD组封堵成功率96.4%(162/168),VSD组94.8%(91/96),PDA组100%(73/73);严重并发症发生率2.8%(9/337),其中Ⅲ度房室传导阻滞6例,心包积液2例,严重主动脉瓣反流并亚急性感染性心内膜炎1例.经过相应治疗除合并亚急性感染性心内膜炎1例死亡外均治愈.结论 经导管介入治疗先天性心脏病,具有创伤小,成功率高,并发症低等特点,是安全、有效的治疗方法,术前正确诊断、术中准确操作和术后认真随访可以减少并发症的发生.

Analysis about complications induced by interventional therapy for congenital heart diseases

Objective To investigate the complications and their prophylaxis in patients with congenital heart disease(CHD) experiencing transcatheter interventional occlusion.Methods A retrospective analysis was performed on the patients'records referred for transcatheter closure for CHD including atrial septal defect(ASD),ventricular septal defect(VSD) or patent ductus arteriosus(PDA) under transthoracic echocardiographic and fluoroscopic guidance at the center of cardiology.The complications were analyzed through electrocardiogram and echocardiography during or after interventional therapy,the outpatients were followed up between six months and one year.Results The interventional procedures of CHD were successfully performed in 325 of 337 patients.The overall achievement ratio of interventional therapy for CHD was 96.4%(325/337),ASD group 96.4%(162/168),VSD group 94.8%(91/96),PDA group 100%(73/73).The incidence of the severe complication was 2.8%(7/337).One patient died of infective endocarditis after two months,others cured.Conclusion Transcatheter interventional therapy for CHD is safe and effective.The complications are markedly reduced by correct diagnoses before operation,accurate technique during operation and intensive monitoring after operation.Careful long follow-up is a necessary procedure.