小儿特殊类型房间隔缺损介入治疗

目的:探讨小儿特殊类型房间隔缺损(ASD)封堵术的方法和疗效。方法:1998年11月至2009年12月,应用双盘伞ASD封堵器治疗390例继发孔ASD,其中88例为特殊类型的ASD,分别为:多发性ASD 24例、短残边ASD 64例。其中男性39例,女性49例;年龄3～18岁,平均6岁;术前均经体检、心电图、X线片及超声心动图确诊,术后行心脏超声及临床检查随访。结果:85例患者介入治疗手术获得成功,技术成功率96.6%。ASD直径为5～26 mm,平均直径为(12.7±4.7)mm。24例多孔ASD,有23例置入1个封堵器,1例应用2个封堵器。在平均5年随访中没有严重并发症。结论:小儿特殊类型ASD可通过心导管介入技术来治愈。

The interventional therapy of unusual atrial septaldefect in children

Objective:To assess the effect and methology in occlusion of Unusual secundum atrial septal defects(ASD) in children.Methods:The transcatheter closure of unusual ASD was performed in 88 children from Nov.1998 to Dec.2009,of whom 24cases had multiple openings,64 cases with edge-insufficiency.Total 88(39male,49female)patients,aged from 3 to 18(12.7±4.7) years old.All of them were confirmed by physical examination,ECG,X-ray and transthoracic echocardiography.Results:The devices were implanted successfully in 85 cases,the technique success rate was 96.6%.ASD was from(5-26)mm,(mean 12.7±4.7) mm.In 24 cases with multiple ASD,23 cases implanted only one occluder to close multiple ASD holes,another 1 case,in which the distance between each ASD holes were 10 mm,were closed by implanting two occluders(14mm,10mm).At a median follow-up interval of 5years there were no complications.Conclusion:It is suggested that interventional therapy are safe and effective for the unusual ASD.