国产封堵器介入治疗室间隔缺损69例

目的评价国产封堵器介入治疗室间隔缺损(VSD)的安全性及疗效。方法69例室间隔缺损(男24例,女45例),其中膜周部(PMVSD)50例、嵴内型(IVSD)9例、干下型(SVSD)8例、肌部2例。PMVSD使用对称型封堵器、IVSD和SVSD使用偏心型封堵器、膜部瘤形成合并多孔型使用对称型封堵器或大边封堵器、急性心肌梗死室间隔穿孔使用房间隔缺损(ASD)封堵器。结果左心室造影测量缺损直径3mm～12mm,平均7.67mm±1.59mm。69例中62例封堵成功,其中50例膜周部缺损,47例成功,8例SVSD4例成功,9例IVSD及2例肌部室缺均成功。1例在术中发生封堵器脱落;1例出现脑栓塞;1例出现溶血;1例Ⅲ度房室传导阻滞。结论介入治疗室间隔缺损,创伤小,成功率高,手术安全,国产封堵器安全、可靠。

The Application of Home-made Occluder in Ventricular Septal Defects: Analysis of 69 Cases.

Objective To assess the efficacy and safety of home-made occluder in transcatheter closure of ventricular septal defects （VSD）. Methods Transcatheter closure was performed in 69 VSD patients（24 men and 45women）, with perimembranous VSD （PMVSD,n= 50）, IVSD（n= 9）, SVSD（n= 8）, and muscular VSD（n= 2）. We used symmetrical VSD occluder in PMVSD, and eccentric VSD occluder in IVSD and SVSD, symmetrical or big-edge VSD occluder in multiporous VSD, and ASD occluder in ventricular septal perforation with acute myocardial infarction. Results The mean VSD diameter was 7.67mm ± 1.59mm, with range 3 - 12mm. The devices were deployed successfully in 62 of 69 patients. However, the occluder device shifted to pulmonary artery occurred in 1 patient, cerebral embolism in 1 patient, haemolysis in 1 patient, and Ⅲ°A- V block in 1 patient. Conclusions Transcather closure operation of VSD is less traumatic, and it has good efficacy. Therefore home-made VSD occluder device is worthy to use widespread.