介入治疗膜周部室间隔缺损的疗效分析

目的探讨应用封堵器介入治疗膜周部室间隔缺损患者方法的安全性及疗效。方法收集2009年3月～2012年3月在我院行封堵器介入治疗膜周部室间隔缺损患者16例，男7例，女9例，年龄15～56岁，平均（13．5±8．6）岁。所有患者经超声多普勒确诊为膜周部室间隔缺损，缺损为2～13mm，平均（3．6±2．5）mm，在影像学引导下经股静脉途径放置封堵器治疗缺损，并在术后24h、1个月、3个月、半年和术后1年进行复诊观察疗效。结果16例患者手术全部成功未发生任何重要并发症，封堵后患者行心脏超声检查未见残余分流，术后即刻封堵率为100％。术后24h、1个月、3个月、半年和术后1年经胸超声心动图检查无残余分流，X线检查全部显示肺血减少，心胸比例不同程度缩小。1例患者术后1个月出现完全性左束支传导阻滞，术后3个月随访时左束支传导阻滞消失。结论封堵器介入治疗膜周部室间隔缺损是一种安全有效的治疗方法，近期疗效证明该方法值得临床上推广使用。

Clinical analysis of transcatheter closure of perimembranous ventricular septal defect

Objective To evaluate the clinical feature of patients with perimembranous ventrieular septal and the safety and efficacy of transcatheter closure of PVS in patients. Methods Between Mar 2009 and Mar 2012, 16 patients （7 men and 9 women） aged 15-56 （13.5±8.6） years underwent attempted transcatheter PVS closure. The diameter of PVS measured by echoeardiography were 2-13 （3.6±2.5）mm before intervention, ion. All patients were treated witll Amplatzer PVS occluder device or homemade double-disc PVS occluder through the percutaneous procedure under fluoroscopy and transthoracic eehocardiography. All the patients were reexamined 24 h, 1,3,6 and 1 2 months after the operation. Results A total of 16 patients were all successful in transcatheter. None pterygium was recurrence and no complication happened. No residual shunt was found by the transthoracic eehocardiography after the procedure in all patients. The cardiac function improved after the intervention in all patients.A complete left bundle branch block happened in 1 months after operation and disappeared in 3 months after operation. Conclusion Transcatheter closure of seeundunt PVS is all efficient and safe method for aged patients.