房室间隔缺损介入治疗失败后外科手术治疗的回顾性分析

目的探讨房室间隔缺损介入治疗失败后外科手术的原因及效果,以提高手术成功率。方法选择2000年1月至2007年12月接受经导管介入治疗房间隔缺损（ASD）和室间隔缺损（VSD）失败后,需行外科手术的13例病例进行回顾性分析。外科手术指征为封堵器脱落7例、Ⅲ°房室传导阻滞（AVB）3例、瓣膜关闭不全2例（其中1例同时合并Ⅲ°AVB）、残余漏1例、封堵失败1例。手术均在体外循环下进行,取出封堵器,修复心内畸形,术后入ICU监护。结果ASD介入治疗患者中,手术探查ASD直径平均31mm,较术前诊断的平均26mm增大,两者相比差异有统计学意义（P〈0.05）。ASD部位为中央型3例,下腔型6例,与术前诊断符合率为41.7%,不符合率为58.3%（P〉0.05）。3例Ⅲ°AVB者术后均恢复窦性心律。心内畸形修复完善,无手术死亡。结论及时采取外科手术治疗介入封堵失败后并发症,效果良好,安全可靠,可避免治疗失败及术后并发症。

Surgical treatment of atrial and ventricular septal defects after unsuccessful interventional therapy: a retrospective analysis

Objective To investigate the causes of failure in treating atrial septal defect(ASD) and ventricular septal defect(VSD) with interventional procedures and to evaluate the clinical efficacy of surgical treatment in order to increase the successful rate.Methods A total of 13 patients,who underwent surgical therapy because of unsuccessful interventional treatment for ASD or VSD during the period of January 2001-December 2007,were selected,and the clinical data were retrospectively analyzed.The surgical indicat...