继发孔型房间隔缺损介入治疗及其疗效评价

目的：评价双盘封堵器介入治疗继发孔型房间隔缺损(ASD)的临床疗效及安全性。方法：在X线透视和经食道超声心动图(TEE；13岁以下儿童经胸超声心动图，TTE)监视下，采用经皮穿刺放置封堵器方法治疗继发孔型ASD16例，术后立刻、24h、1月、3月进行TEE或TTE和X线胸片检查，以评价其疗效。结果：本组16例封堵器置入均获成功。其中9例术后胸闷症状立即消失，第2天即能下床活动，无特殊不适主诉；另7例症状任2周后逐渐好转。1例术后仍有微量分流，3个月后分流才消失；术后1个月有8例右房及右室内径较术前缩小。14例术后3个月TTE显示ASD无残余分流，封堵器位置良好；另2例失访。结论：经皮封堵治疗继发孔型ASD，是一种有效的介入治疗方法，具有安全、有效、操作简便，成功率高的特点。

The Clinical Efficiency of Atrial Septal Defect Occlusion with Homemade Occluder

Objective:To evaluate the clinical efficiency of homemade occlusion device in treatment of atrial septal defects(ASD).Methods:16 patients with ASD underwent transcatheter closure with the homemade double-umprella device.Transthoracic chocardiography was made immediately,24 hours,one month and 3months respectively after the intervention to evaluate the treatment efficiency. Results:All the cases of ASD were occluded successfully.The symptoms disappeared immediately in 9 patients after the intervention.The symptoms disappeared gradually in 7 patients after 2 weeks.Small residual shunts were found in one patient immediately after the procedure and recovered 3 months later.The diameter of the right atrium and ventricle became smaller in 8 patients after the procedure.14 patients had no displacement or residual snunts 3 months after the intervention.Conclusion:Transcatheter colosure of secundum ASD using atrial septal occluder is safe,efficient and feasible.