经导管同期封堵治疗膜周部室间隔缺损合并房间隔缺损

目的　探讨经导管介入同期治疗膜周部室间隔缺损 (VSD)合并房间隔缺损 (ASD)的可行性、方法及疗效。方法　 4例患者 ,年龄为 12～ 2 6岁。术前超声检查提示VSD合并ASD。VSD均为膜周部缺损 ,缺损直径 3～ 6mm ,缺损上缘距主动脉瓣 2～ 6mm。ASD均为继发孔型 ,缺损直径 5～ 8mm。4例患者均于术中先行左心室造影 ,确定VSD适合封堵后 ,先行VSD封堵 ,最后行ASD封堵。结果　 4例患者均经导管一次封堵治疗成功。左心室造影显示VSD呈囊袋型 3例 ,囊袋直径分别为 4、5和 10mm ,封堵器的直径分别为 4、8和 12mm。 1例缺损为管状 ,直径 3.5mm ,用 4mm的封堵器治疗成功。4例患者ASD伸展径为 6～ 10mm ,封堵器直径为 6～ 12mm。所有患者术中及术后无并发症。结论　经导管介入同期封堵治疗膜周部VSD合并ASD具有技术上的可行性、安全性和良好的治疗效果

Simultaneous transcatheter therapy of perimembranous ventricular septal defect combined with atrial septal defect

Objective To evaluate the possibility, methods and efficiency of simultaneous transcatheter therapy for perimembranous ventricular septal defect(PMVSD) combined with atrial septal defect(ASD).Methods Four patients with PMVSD combined with ASD, including 3 males and 1 female, age ranging from 12 to 26 years; underwent simultaneous attempted transcatheter therapy. The diameters of PMVSD were 3-6 mm and the distances from the defect rim to aortic valve were 2-6 mm by the echocardiography before the precedure. The stretched diameter of ASD was 6-10 mm. PMVSD were occluded using homemade two-disc PMVSD occluder first and the ASD were occluded later on. Results All patients were treated successfully at one time. The diameter of PMVSD were 3.5-10.0 mm, the diameters of occluder was 4-12 mm. The stretched diameter of ASD was 6-10 mm and the occluder diameter was 6-12 mm. No residual shunt was found by the transthoracic echocardiography and left ventriculography after the occluders deployed. No complication occurred. Conclusion Simultaneous transcatheter therapy for PMVSD combined with ASD is feasible, safe and effective.