多发性房间隔缺损介入治疗

目的本文报告1998年10月-2006年11月13例多发性ASD介入治疗体会。方法13例中男3例,女10例。年龄4~60岁,平均(26.1±4.2)岁。13例中9例2处缺损,3例3处缺损,1例4处缺损。合并房间隔膨出瘤2例,1例合并心房纤颤和心包积液。结果13例中11例应用一个闭合器功闭合,闭合器型号12~40 mm,2例应用两个闭合器闭合缺损,型号均为18/8 mm,2例术后残余分流。无其它并发症。结论多发性ASD介入治疗,必用TEE监测,确定ASD数目、直径和间距,尽量用1个闭合器闭合多处缺损。

Percutaneous closure of multi-fenestrated atrial septal defect

Objective This study reports our clinical experience of transcatheter device occlusion of multi-fenestrated atrial septal defect(ASD). Methods From December 1998 to November 2006, 13 patients, 3 males, 10 females, at a mean age of (26.1±4.2) years (ranged from 4 to 60 years old), underwent percutaneous closure of multi-fenestrated ASD. Out of the 13 patients, 9 had two defects, 3 detected three defects, 1 had four defects. Two of 13 patients accompanied atrial septal aneurysm, one accompanied atrial fibrillation and hydropericardium. Results 11 of 13 patients were successfully treated with single occluder(device size ranged from 12 to 40 mm), 2 were implanted two devices for effective closure of all defects(occluder diameter 18 and 8 mm). During follow-up, residual shunting was observed in 2 of 13 patients, and no other complications were noted. Conclusion Multi-fenestrated ASDs should be closed under transesophageal echocardiographic(TEE) guidance to determine number, diameter and distance of ASDs. We should try our best to close multi-fenestrated ASDs with one device.