继发孔型房间隔缺损介入性封堵术27例临床报告

目的 评价应用ＡＧＡ Ａｍｐｌａｔｚｅｒ闭合器对非开胸手术闭合继发孔型房间隔缺损的疗效。方法 ２７例ＡＳＤ住院患者，男７例，女２０例。年龄３￣４９岁，平均３１．９岁。体重１８￣８８ｋｇ，平均５８．２ｋｇ。ＡＳＤ病理分型；中央型２４例，中央偏上型２例，下腔型１例。其中单一ＡＳＤ２５例，多发性ＡＳＤ２例（２处缺损１例，３处缺损１例），合并肺动脉瓣狭窄（ＰＳ）和合并房间隔膨出瘤各１例，ＡＳＤ直径１．０￣

Clinical report on transcatheter closure of atrial septal defects in 27 patients

Objective To evaluate the safety and efficiency of transcatheter closure of secundum atrial septal defect (ASD) with Amplatzer occlusion device. Methods Twenty seven patients of ASD, 7 males, 20 females, with a mean age 27.5 (ranged from 3 to 49) years, mean weight 58 (ranged from 18 to 88) kg were studied. The pathologic classification of ASD: 24 were central type, 2 were super central type, 1 was inferior cava type. Of 27 patients, 25 were single defect, 2 were multiple, with one of two defects, another of three defects; 1 was complicated with pulmonary stenosis (PS), 1 with interatrial septal aneurysm. The diameter of ASD (balloon stretched diameter) was 1 0-3 6 cm. 26 patients underwent the proceduce with Amplatzer occlusion device. The device was advanced to ASD with a 7-12F long guiding sheath and deployed under fluoroscopic and ultrasound guidance. The Amplatzer occluder size was chosen to be equal to or 1 mm more than the streched diameter of ASD. Results Of 27 patients, 26 had successful implantation of the Amplatzer device, one was not. Successful modulus was 96%. No complications were observed in 26 except one with cerebral embolism after deployment of the prothesis, who was actively treated and recovered in 15 days. No residual shunt was found in all patients. Conclusion The Amplatzer is an efficient prosthesis that can be safely applied in patients with ASD.