经导管先天性心脏病封堵术综合疗效评价及心脏超声的动态研究

①目的　探讨经导管先天性心脏病封堵术的可行性及安全性,进行多因素综合疗效评价。②方法通过经胸超声心动图(TTE)选择适合封堵术的先天性心脏病病人46例,其中房间隔缺损(ASD)20例,室间隔缺损(VSD)19例,动脉导管未闭(PDA)7例。在TTE及X线引导下行介入封堵术,术后通过TTE进行动态的随访观察。③结果　46例病人全部封堵成功,技术成功率为100%;术后5 例病人有微量至少量残余分流;1 例出现阵发性房颤,1例出现一过性完全性右束支传导阻滞(RBBB),无其他严重并发症发生。ASD、VSD及PDA术前TTE测量值与术中X线测量值比较无显著性差异(t=0.222~1.136,P>0.05)。术后50%以上病人接受了3~6 个月随访。④结论　经导管先天性心脏病封堵术具有很高的成功率及安全性;介入封堵术疗效好、并发症少、术后恢复快;TTE可以准确地应用于先天性心脏病封堵术中。

MULTIPLE-FACTOR ANALYSIS AND ULTRASOUND DYNAMIC RESEARCH OF TRANSCATHETER TREATMENT OF CONGENITAL HEART DISEASE

Objective To evaluate the efficacy and safety of transcatheter occlusion of congenital heart diseases through multiple-factor and comprehensive analysis. Methods Forty-six patients with congenital heart diseases were chosen using transthoracic echocardiography(TTE): 20 with atrial septal defect (ASD), 19 with ventricular septal defect(VSD), seven with patent ductus arteriosus (PDA). The defect closure was performed under the guidance of TTE and X-ray. The patients were followed with TTE after the procedure. Results The success rate was 100% in this study. Trace to small quantity of residual shunt was observed in five patients, paroxysmal atrial fibrillation in one, and right bundle branch block(RBBB) in one patient. There were no significant differences in measurement by TTE between, before and after the transcatheter procedures, PDA,ASD and VSD patients (t=0.222-1.136, P>0.05). More than 50% of the cases were followed up for 3-6 months after the closure. Conclusion With high success rate and safety, transcatheter closure has good efficacy and few complications. TTE plays an effective role in transcatheter closure of congenital heart diseases.