应用Amplatzer封堵器治疗膜周部室间隔缺损20例

目的:观察应用Amplatzer封堵器经导管介入治疗先天性心脏病膜周部室间隔缺损(PMVSD)的可行性、安全性和疗效。方法:采用Amplatzer封堵器治疗先天性心脏病膜部室间隔缺损20例患者,术前由经胸超声心动图确诊PMVSD,术中经左心室造影明确缺损位置、直径、在透视及超声心动图监视下经导管置入Amplatzer封堵器封堵PMVSD,术后3d、3个月、6个月及1年分别行经胸超声心动图、心电图和X线检查。评价治疗效果。结果:20例VSD病人成功置入Amplatzer封堵器,透视及超声心动图显示即刻完全堵闭。术后出现溶血和三度房室传导阻滞各1例,对症治疗后消失。分别手术后3个月、6个月、1年随访,超声心动图示封堵器位置良好,19例完全闭合,仅1例残余分流,无严重并发症。结论:经导管置入Amplatzer封堵器治疗PMVSD是一种成功率高、并发症少、疗效可靠的介入方法。

Close of perimembranous ventricular septal defect by Amplatzer occluder in 20 patients

Objective:To observe the feasibility,safety and therapeutic effect using the Amplatzer occluder to the perimembranous ventricular septal defect(PMVSD).Methods:The 20 PMVSD patients underwent transcatheter closure with the Amplatzer occluder.They were diagnosed and identified the position and diameter of PMVSP by transthoracic echocardiography(TTE).During transcatheter closure with the Amplatzer occluder,they were monitored by X-ray machine and TTE.To evaluate the therapeutic effect,they were followed with TTE,electrocardiogram and X-ray.Results:All 20 cases patients with PMVSD were occluded with the Amplatzer successfully.There were one case of hemolysis and one case of third degree A-V block.They were cured by symptomatic treatment.The follow result showed that the occluder fixed well,complete close in 19 cases,only one case with reside shunt and no serious cardiac arrhythmias.Conclusion:The Amplatzer occluder closure is an effective and safety intervention with few complications.