继发孔型房间隔缺损封堵术的临床应用分析

目的评价继发孔型房间隔缺损（ASD）封堵术的临床疗效及安全性,探讨ASD介入治疗的影响因素.方法在经胸心脏超声（TTE）及X线透视下经导管置入封堵器,术后24h、72h、1个月行TTE检查评价治疗效果.结果 342例患者除4例因房缺太大,2例合并不可逆肺动脉高压外,置入均成功,技术成功率达100%,封堵效果佳,未见残余分流,1月后随访右室收缩压明显下降.结论 ASD封堵术是一种安全有效的介入治疗方法,但需掌握好手术适应症,ASD大小及边缘、合并其它先心病、房间隔膨出瘤和肺动脉高压等因素直接影响手术的成功。

The Clinical Application of Transcatheter Closure for Secundum Atrial Septal Defect

Objective Toevaluate the efficacyand safetyoftranscatheter closure for secundumatrial septal defect,and to explore the influencing factors of ASD interventional therapy.Method Under the guidance of TTE and X-ray,the appropriate occluder device was planted.TTE was performed to evaluate the efficiency of transcatheter closure for secundum atrial septal defect 24 hours,72 hours,and 1 month after the procedure.Results Three hundred and thirty-six patients with secundum ASD were treated using occluder device through the percutaneous procedure.The success rate of the technique was 100%,except the size of ASD was too large to be occluded in four cases,and two cases merging irreversible pulmonary hypertension.No complications occurred during procedure.No residual shunts were found.There was improvement in the symptoms and in cardiac size,and right ventricle systolic pressure declined significantly in all patients after 1 months follow-up.Conclusion Transcatheter closure using occluder device is an efficient and safe interventional procedure for patients with ASD.The success of transcatheter closure is associated directly with the factors such as the edge of ASD,mergering other congenital heart disease,interventricular septal bulged aneurysm（IVSBA） and pulmonary hypertension.