可调弯鞘经颈内静脉微创房间隔缺损封堵术

目的：评价可调弯鞘经颈内静脉超声引导下房间隔缺损（ASD）封堵术治疗先天性心脏病的临床效果。方法回顾性分析2015年12月至2016年3月采用可调弯鞘经颈内静脉房间隔缺损封堵术，7例先天性心脏病房间隔缺损患者的临床资料，男2例，女5例；年龄23-47岁；体重39.6-64.5kg。术后一周及1个月内各随访心电图及超声心动图1次，3个月后再次复查心电图及超声心动图。观察手术治疗效果。结果7例患者均成功实施经颈内静脉房间隔缺损微创封堵手术；手术时间22-40min，术后呼吸机辅助时间2-4.5 h，ICU停留时间6-32 h，术后住院时间2-3 d。所有患者均痊愈出院，术后1周、1、3个月随访行超声心动图及心电图检查显示7例患者封堵器位置均良好，未见残余分流及血栓形成，无Ⅲ度房室传导阻滞。结论超声引导下经右颈内静脉可调弯鞘ASD封堵术较传统的经皮介入封堵、经胸封堵有明显优势，是一种创伤更加轻微、操作简单的新的术式。

Occlusion of Trans-jugular Venous Minimal Invasive Surgery on Atrial Septal Defect with Curve-controllable Sheath Catheter

Objective To evaluate a new operation of Occlusion of trans-jugular venous minimal invasive surgery on atrial septal defect with curve-controllable sheath catheter. Methods From December 2015 to March 2016, 7 patients with atrial septal defect (ASD) underwent trans-jugular vein closure using the curve-controllable sheath catheter were analyzed retrospective. These patients were 23-47years old and weighed 39.6-64.5kg,male and female 2 and 5 cases. Results All patients were performed minimal invasive surgery successfully. The average procedure time was 22-40 minutes. The ventilator was used for 2-4.5h.The patients stayed in ICU for 6-32h,and the postoperative hospitalization stay was 2-3days. All patients survived and were discharged. The one week and 1, 3month follow up examination with the postoperative echocardiography and ECG indicate that no residual shunt, no occluder dislocation and noⅢstage atrioventricular block. Conclusion It is a new surgical method with simple operation, mild damage. It has advantages over traditional percutaneous and transtrhoracic closure of ASD.