经导管应用双盘状封堵器治疗膜部室间隔缺损56例临床研究

目的 :探讨经导管应用双盘状封堵器治疗膜部室间隔缺损 ( VSD)及其疗效。方法 :对 5 6例 VSD直径为 3.0～ 1 0 .0 mm2～ 1 5岁患儿 ,经导管置入双盘状封堵器 ,封堵后即刻行左心室造影 ,术后 1 d、3d、7d及 1月行超声心动图检查观察有无残余分流及封堵器位置。结果 :全组 5 6例封堵器植入成功 ,技术成功率 1 0 0 %。术后即刻左心室造影存在微量至少量残余分流 6例 ( 1 0 .7% ) ,5 0例 ( 89.2 % )封堵完全无残余分流。术后 2 4～ 48h超声心动图示分流完全消失 5 4例 ( 96.4% )、微少量残余分流 2例 ( 3.6% )。 1例封堵术后 2 4 h发生溶血 ,经过7d内科保守治疗治愈。2例封堵术后 3d发生 °房室传导阻滞 ,经过 4～ 1 0 d内科保守治疗痊愈。 1月超声心动图未见残余分流及再通。结论 :应用双盘状封堵器治疗室间隔缺损是一种安全有效的介入方法。

Transcatheter closure of ventricular septal defects using the domestic-made VSD occluder(a report of 56 cases)

Objective:To evaluate the treatment efficiency of transcatheter closure of ventricular septal defect(VSD) using the domestic made occluder device. Methods:56 patients with VSD underwent attempted transcatheter closure of a VSD using the domestic made occluder device at a median age of 8.6±4.3years (range 2.0 to 15).The mean VSD diameter at its left ventricular side was 7.4±2.5mm (rang 3.0～10.0).A 7F or 8F long sheath was used for delivery of the device. The left ventricular graphies(LVG) were performed to evaluate the closure results immediately after the procedure. Echocardiographies and ECG were performed 1 day, 1 month after the closure to find whether there was residual shunt and recanalization. Results:The technical success rate of the group was 100%. LVG showed that 50(89.2%) patients had complete closure immediately. Within 24～48h, color doppler revealed complete closure in 54 patients(96.4%) and a trace to small shunt in 2 patients(3.6%).Two cases suffered with temporary Ⅲ°atrial ventricular block and returned to normal 4～10 days after drug treatment. One patient developed hemolysis 24h after the procedure and recovered 7 days after drug treatment. No residual shunt and VSD recanlization were found in 1 month after the procedure. Conclusion:Transcatheter method of VSD occlusion using domestic made VSD occluder is safe and effective.