应用国产封堵器经导管治疗膜周部室间隔缺损的临床疗效评价

目的评价应用国产封堵器经导管治疗膜周部室间隔缺损（VSD）的临床疗效。方法共20例膜周部VSD患者,男性9例,女性11例,平均年龄15.6岁（3～35岁）,其中10例伴有膜部瘤。采用国产室间隔缺损封堵器在透视及超声监测下进行VSD封堵术,术后即刻行左室造影、升主动脉造影及经胸超声心动图（TTE）检查验证即刻疗效,术后24h、1个月、3个月、6个月、12个月行心电图、TTE、X线胸片随访复查。结果18例患者经导管治疗成功,2例因未能成功建立动静脉轨道而放弃封堵,技术成功率90%（18/20）。5例患者术后即刻造影及TTE检查显示少量残余分流,24h后超声检查证实残余分流消失,其余均即刻达到完全封堵,24h内完全封堵率100%。1例患者术后24h出现交界性逸搏心律,3d后恢复正常,无其他严重并发症发生。18例患者平均随访7.8个月（1～24个月）,无封堵器移位、晚发心律失常等并发症发生。结论应用国产封堵器对膜周部室间隔缺损进行介入治疗,疗效确切,近期临床效果满意。

The clinical efficacy of transcatheter closure of ventricular septal defect with home-made occlusion device

Objective To evaluate the clinical efficacy of transcatheter closure of ventricular septal defect with home-made occlusion device.Methods 20 patients were included,among whom 9 were male and 11 were female（age from 3 to 35 years）,Of which 10 cases of aneurysm associated with membranous.Domestic ventricular septal defect occluder with fluoroscopy and ultrasound monitoring of patients under the VSD occluder.Immediately after left ventricular angiography,ascending aortic angiography and transthoracic echocardiography（TTE）examination certification effect immediately.After 24 h,1 month,3 months,6 months,12 months line ECG,TTE,X-ray follow-up review.Results 18 patients with transcatheter treatment success,technical success rate of 90%（18/20）.5 cases of immediate postoperative angiography and TTE examination showed a small amount of residual shunt.24 h after the ultrasound examination confirmed the residual shunt disappeared,the rest were immediately to achieve complete occlusion,24 h in complete occlusion rate of 100%.One patient after 24 h there junctional escape rhythm Bo,3 d after the return to normal,no other serious complications occurred.18 patients with an average follow-up of 7.8 months（1～24 months）,no occluder displacement,late-onset arrhythmias and other complications occurred.No occluder displacement,late-onset arrhythmias and other complications occurred.Conclusion Applications made occluder right perimembranous ventricular septal defects for interventional treatment,curative effect,short-term clinical results were satisfactory.