经导管同期封堵治疗室间隔缺损合并房间隔缺损

目的：探讨经导管同期封堵治疗室间隔缺损（ventricular septal defect，VSD）合并房间隔缺损（atrial septal defect，ASD）的可行性、方法及疗效。方法：68例VSD患者中有4例合并有ASD，4例患者年龄为3-24岁。术前超声心动图检查示VSD均为膜周部缺损，缺损直径2-10．5mm，ASD均为继发孔型，缺损直径4．6-7mm。4例患者均于术中先行左心室造影，确定VSD适合封堵后，3例先行VSD封堵，最后行ASD封堵，1例仅行VSD封堵。结果：4例患者均经导管一次封堵VSD成功，VSD封堵器的直径分别为4，8，10，16mm。3例患者经导管一次封堵ASD成功，ASD封堵器直径分别为8，10，10mm，封堵成功率100％，患者术中、术后及随访无并发症。结论：经导管同期封堵治疗VSD合并ASD是一种安全、可行和疗效良好的介入治疗方法。

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OBJECTIVE: To access the possibility, methods and efficacy of simultaneous transcatheter therapy for ventricular septal defect ( VSD ) combined with atrial septal defect (ASD). METHODS: In 68 patients with VSD, four patients ranging from 3 to 24 years old were combined with ASD. The diameters of perimembranous VSD were 2 approximately 10.5 mm, and the diameters of secundum ASD were 4.6 approximately 7 mm under the echocardiography before the operation. Another 4 patients with VSD occluded by left ventriculography: 3 patients were occluded by VSD occluder first, and then occluded by ASD occuder. The other was only occluded by VSD occluder. RESULTS: All VSD was treated successfully at one time in 4 patients. The diameters of VSD occluder were 4, 8, 10, and 16 mm. ASD was occluded successfully at one time in 3 patients. The diameters of ASD occluder were 8, 10, and 10 mm. The successful rate of the operation was 100%. No complication occurred in the operation and follow-up. CONCLUSION: Simultaneous transcatheter closure for VSD combined with ASD is a safe, feasible and effective therapy.