偏心型封堵器治疗先天性干下型室间隔缺损的探讨

目的探讨先天性干下型室间隔缺损(VSD)偏心型封堵器介入治疗的可行性及近期疗效。方法经皮介入治疗先天性干下型室间隔缺损患者7例。经胸超声心动图提示VSD的直径为4~8mm,缺损上缘距主动脉瓣的距离1~2mm,距肺动脉瓣距离4~6mm,轻度主动脉瓣反流6例,中度1例。均选用偏心型VSD封堵器治疗。术中在右前斜45度下行左室造影、建立股动静脉轨道、经右心系统释放封堵器,并分别于术后2周、1个月、3个月、6个月进行随访。结果7例患者封堵器均成功置入。术后即刻超声及造影示完全封堵6例,少量残余分流1例,在3个月后消失。封堵器对主动脉瓣、肺动脉瓣和房室瓣均无影响,术中及术后未有其它严重并发症发生。结论应用偏心型封堵器经皮介入治疗先天性干下型室间隔缺损是安全有效的,近期效果良好。

Transcatheter Closure of Congenital Subarterlal Ventricular septal Defect using Asymmetric Ventricular Septal Defect Occluder.

Objective To study the feasibility and efficacy of transcatheter closure of congenital subarterial ventricular septal defect （VSD）. Methods From March 2006 to May 2007, 7 patients with subarterial VSD underwent transcatheter closure. The diameter of VSD measured by transthoracie echocardiography was ranged from 4 to 8nun. The distance between superior border of defect and aortie valve was ranged from 1 to 2mm. The distance between superior border of defect and pulmonary valve was ranged from 4 to 6mm. Asymmetric VSD oeeluder was used for all patients. All patients underwent left ventrieulography before catheter closure and rechecked eehoeardiography, ECG, chest X-ray at 2 weeks, 1 month, 3 months and 6 months after the procedures. Results The devices were implanted successfully in all patients. 6 patients with VSD closed immediately, and nfild residual shunt was found in 1 patient. The residual shunt disappeared Mthin 3 months follow-up period. There were no valvular insufficiency and no other severe complications. Conclusions Tmnscatheter closure of subarterial VSD with asymmetric VSD occlude is safe and effective, short-term outcome is good.