双Watchman封堵器对吻封堵单叶大开口左心耳1例

<正>1 临床资料患者,男性,55岁。主因"阵发性心慌、气短1年半,加重20余天"入院。患者于1年半前无明显诱因感心慌、气短,无胸痛,活动后为著,经休息可好转,未经过特殊治疗。3年前患者因"不能言语"至当地医院行心电图检查提示"心房颤动",头颅CT提示"脑梗死"。当地医院诊断为:①脑梗死;②心房颤动。给予阿司匹林100 mg,1次/d。半年前,患者再次出现右上肢麻木,后加重为右侧肢体运动障碍,至外院诊断"脑梗死",给予华法林半片,1次/d     

心耳结扎不完全、房间隔缺损封堵后左心耳封堵1例

<正>1临床资料患者,女性,45岁,主因“间断心慌、胸闷、气短18年,加重1个月”于2019年11月收入空军军医大学第一附属医院心脏内科。患者于18年前出现心慌、胸闷、气短,就诊于本院,行“房间隔缺损（房缺）封堵术”。2017年患者再次出现心慌、胸闷、气短,伴恶心,短暂意识丧失,持续约数秒,就诊于“首都医科大学附属北京安贞医院”,诊断“二、三尖瓣关闭不全、心房颤动（房颤）、房缺封堵术后、短暂脑缺血发作”,行“二尖瓣、三尖瓣成形术、左心耳结扎术、     

纠正性大血管错位伴房间隔缺损1例报道

1 资料 [例1],男,61岁, 以间断性胸闷、气短7年,加重伴心悸7月为主诉.于2004年10月29日入住我院.7年前因劳累后出现胸闷、气短,无胸痛,无头晕、头痛,无咳嗽、咳痰,无颜面四肢水肿,夜间可平卧休息.在当地医院未能明确诊治,此后每遇劳累上述症状加重,休息或自服"氢氯噻嗪、地高辛"后可缓解.近7月来胸闷气短症状加重,伴心慌、双下肢水肿,严重时伴出汗,夜间平卧后感心前区憋胀感,自行静脉输注丹参等药物,症状时好时坏,劳累后加剧,在当地医院行心包穿刺术休克,为进一步诊治转入我科.发病以来,精神食欲差,小便量少.既往体健,生活规律,吸烟量少,偶有饮酒.     

飞行人员房间隔缺损封堵术后新发偏头痛及航空医学鉴定1例

<正>1对象和方法患者,男性,35岁,轰-6空中战勤人员,飞行时间2 100 h。患者于2021年10月19日于我院行空勤人员年度体检时发现房间隔缺损,患者既往体健,一直正常参加飞行,无胸闷、胸痛、心慌、气短和活动后气促等症状。心脏超声：左心房：（左右S）37 mm,右心房：（左右S）46 mm,右心室：（左右D）32 mm,     

封堵治疗先心病房间隔缺损二例

病例 1:患者 ,男 ,5岁。因活动后气短 ,乏力入院 ,一月前在院外行心脏彩超提示先心病房间隔缺损。入院后查体 :一般情况好 ,发育正常 ,面部及口唇无紫绀 ,双肺呼吸音清晰 ,心律齐 ,心率 90次 分 ,未闻及杂音。胸部透视、血生化、心电图正常 ,复查心脏超声显示卵圆窝缺损 14ｍｍ(即二孔型缺损 ) ,房室内未见有血栓。入院后一周行房间隔缺损介入封堵术 ,术中封堵器放置后 ,超声即显示原右房彩色血流频谱被阻断。术后观察三天病情稳定予以出院 ,嘱继用阿斯匹林 2 5ｍｇ 日 ,连续半年。病例 2 :患者 ,男 ,2 8岁 ,因反复短阵心悸、气短 2年入院…     

梅毒性主动脉炎致冠状动脉左主干次全闭塞经皮冠状动脉介入治疗并发冠状动脉穿孔成功治疗1例

正1临床资料患者男,59岁,于2019年7月30日因"发作性胸闷、气短4年,加重10 d"入住西安交通大学第一附属医院。4年前常于快步行走或重体力活动时感到胸闷、气短,无明显胸痛,休息5～6 min后自行缓解,曾在当地医院按"冠心病"诊治,效果不佳。入院前10 d劳动过程中突感胸骨后闷痛,范围约手掌大小,伴心慌、气短和全身冷汗,当地医院急诊冠状动脉造影(coronary angiography,CAG)示:冠状动脉     

老年人类风湿性心脏病合并房间隔缺损一例

老年人类风湿性心脏病合并房间隔缺损一例陶志刚王洪敏患者女性，６４岁。因活动后心慌、气短５年，加重伴夜间不能平卧入睡４天，于１９９４年３月２６日入院。１９８９年初出现活动后心慌、气短，上楼时明显，休息后可缓解，曾在当地医院按“风湿性心脏病”治疗。１９９...     

冷冻球囊消融治疗阵发性心房纤颤1例

<正>1对象和方法患者,女,69岁,44 kg,陕西渭南人,长期居住于城市。主因"阵发性心悸10年,加重1月"入院。患者于10年前无明显诱因感阵发性心悸,无胸闷、胸痛、气短、头晕、晕厥等。曾至当地医院就诊,心电图检查提示阵发性心房纤颤。给予口服阿司匹林肠溶片、胺碘酮、琥珀酸美托洛尔缓释片等药物治疗,症状可缓解。近1月来自觉服用上述药物     

肺泡蛋白沉积症1例

<正>临床资料患者男性,41岁,农民。2017年4月6日以"间断气短2年,咳嗽3d"之主诉入院。既往吸烟10年余,每日20支。2年前患者无明显原因及诱因出现气短,气短以活动后为著,无咳嗽、咳痰、咯血,无发热、乏力、盗汗,无胸闷、胸痛。曾多次就诊当地医院,未见明显异常。未重视,未规范诊疗。3d前患者无明显原因及诱因出现咳嗽,呈阵发性,无明显咳痰,气短不著,无胸闷、胸痛。于当地医院行胸X线     

托伐普坦片治疗心力衰竭合并低钠血症1例

<正>1病例患者,男性,46岁,主因"反复胸闷气短3年,加重1周",于2016-4-10收入我院。患者3年前无明显诱因出现胸闷、气短,活动后加重,就诊于当地医院,诊断为"扩张性心肌病心力衰竭",予以强心、利尿等改善心功能治疗后上述症状好转出院。此后上述症状反复发作,多次就诊于当地医院;1周前劳累后再发胸闷气短,双下肢逐渐水肿,夜间不能平卧。既往服用依那普利、美托洛尔、呋塞米、螺内酯,地高辛等药物辅助治疗。     

左心耳封堵联合房间隔缺损封堵“一站式”治疗对房间隔缺损合并房颤患者的安全性及疗效观察

目的 探讨对先天性房间隔缺损合并房颤的患者,同期进行经皮左心耳联合房间隔缺损封堵术的可行性、安全性及疗效。 方法 回顾性分析珠海市人民医院及四川省人民医院2016年1月-2018年6月收治的13例先天性房间隔缺损合并房颤的患者的临床资料,术后即刻评价封堵疗效,并于术后45天,90天随访观察左心耳和房间隔封堵器的位置、血栓形成以及残余分流情况及患者临床表现。结果 13例患者均成功植入WATCHMAN左心耳封堵器及双盘式房间隔缺损封堵器。术后即刻封堵效果满意,房缺封堵器封堵器位置满意,固定,无残余分流,WATCHMAN封堵器符合PASS原则,术中无器械表面血栓,无心包填塞及血管并发症。随访结果显示,13例患者无新发脑卒中者;未发现心功能恶化者;未发现封堵器移位;未发现左心耳封堵器残余分流加重及器械表面血栓。其中1例患者自行转为窦性心律。结论 对先天性房间隔缺损合并房颤患者,同期实施左心耳联合房间隔缺损封堵术具有操作安全简便的特点,近、中期的随访效果良好。     

Laceration of atrial septum during balloon sizing of atrial septal defect.

We read with great interest the recently published case reportby Alsaileek et al.¹ in the European Journal of Echocardiographyon laceration of atrial septum during balloon sizing. We hadalready reported about tear of atrial septum during balloonsizing of atrial septal defect (ASD) in a 20-year-old female.²Balloon     

Atrioventricular septal defect with a well developed primary component of the atrial septum ("septum primum")

A heart is described with an atrioventricular septal defect in which the lower part of the atrial septum ("septum primum") was well developed and in which superior and inferior bridging leaflets were attached neither to the crest of the ventricular septum nor the inferior rim of the atrial septum. Diagnostic pre-operative angiographic and echocardiographic features and the method of surgical correction are outlined.     

正常儿童与继发孔型房间隔缺损患儿房间隔径的对比

目的：观察儿童时期房间隔直径及其继发孔房间隔缺损（ASD）患儿的房间隔直径的解剖特点。方法：选择正常儿童500例和单纯ASD患儿206例按照体表面积分成10组,用超声心动图常规取心尖四腔心和剑下四腔心切面测量每一例儿童房间隔直径（IAS）,结果：获得正常儿童和单纯ASD患儿不同生长发育时期的IAS,得知同一体表面积组ASD患儿较正常儿童的IAS径长,探索从胸前或剑下切面测量和观察IAS和ASD直径,ASD患儿的IAS与ASD径有相关性。结论：对儿童IAS径的测量是经导管关闭,ASD术病例选择中须考虑的重要条件。探索不同发育阶段IAS径的规律性,可帮助选择恰当的病例进行导管介入关闭ASD,减少并发症,提高成功率。     

A patient with an unusual cyst of the inter‐atrial septum and atrial sepal defect

Hepatic and renal cysts are relatively common among healthy people, but there are few published reports of primary cysts of the atrial septum. Here, we report a case of an unusual cyst of the atrial septum accompanied by atrial septal defect (ASD) in a 42‐year‐old woman. Microscopic examination showed the deposition of calcium salts within the tissue mass and an organized thrombus surrounded by a fibrous capsule. The case was discussed with reference to the relevant published literature and compared to other documented types of atrial septal cysts. The final diagnostic conclusion was a primary atrial septal cyst.     

Echocardiographic visualization of laceration of atrial septum during balloon sizing of atrial septal defect.

Transcatheter closure of atrial septal defect (ASD) has become an accepted alternative to surgery. A number of complications associated with ASD device closure have been recognized but most are rare or minor in severity. We report a rare complication of atrial septal laceration during transcatheter closure of secundum ASD. We discuss the diagnostic confusion, which resulted in the decision for surgical correction.     

Closure of ostium secundum atrial septum defect with the Atriasept occluder: Early European experience

Objectives : This multicentre study sought to report the safety and efficacy of the ATRIASEPT septal occluder to repair atrial septal defect (ASD). Background : The ATRIASEPT is a low profile, flexible, double disk occluder with centering system specifically designed for closure of ostium secundum ASD. Method : Patients were enrolled from four participating European sites and followed up for 12 months post procedure. Outcomes were evaluated, including closure success and incidence of adverse events. Results : Seventy‐six patients received the ATRIASEPT device. Mean size of the defect was 15 ± 4 mm. Closure success was observed in 69 patients (89%) at the end of the procedure. Sixty‐four patients had a six‐month follow up with a complete closure by 58 patients (90%). Minor adverse events occurred in two patients. Significant functional improvement was reported by all symptomatic patients. Conclusion : Percutaneous closure of ASD ostium secundum type defects with the ATRIASEPT is safe and effective with high success rate and excellent mid‐term outcome. © 2010 Wiley‐Liss, Inc.     

Electrocardiographic picture in patients with congenital defect of atrial septum operated upon in adult age

Electrocardiograms from 30 patients with congenital atrial septal defect operated upon in adult age were analyzed. One of frequent variants of QRS configuration in standard leads was SIqIII type. It was observed in 50% of patients. Most frequent (in 67% of patients) variants of QRS configuration in lead V1 were rSr' and rSR'. Signs of right ventricular hypertrophy were most often found in a group of patients with high pulmonary hypertension. Changes of terminal portion of ventricular complex such as negative or biphasic T waves were found in 29 of 30 patients (in 63% of cases these changes were localized in leads V1-V3).