先天性心脏病介入治疗122例临床疗效分析

目的:探讨先天性心脏病(CHD)经皮介入治疗方法及其近期疗效。方法:回顾性分析我院2000年1月至2007年9月连续施行的CHD介入治疗122例,其中房间隔缺损(ASD)封堵术53例,室间隔缺损(VSD)封堵术7例,动脉导管未闭(PDA)封堵术48例,肺动脉瓣狭窄(PS)球囊扩张术(PBPV)14例,采用经皮穿刺股静脉和(或)股动脉法,术前、术后行左、右心导管造影检查,术中联合使用超声心动图引导。结果:122例CHD介入治疗,技术成功120例,2例未封堵成功,成功率98.4%。ASD患者53例中,52例封堵成功,发生并发症3例。VSD患者7例,6例介入治疗成功,发生并发症1例。PDA患者48例,均封堵成功,7例发生外周血管并发症。PS患者14例行PBPV均成功扩张,均使用单球囊扩张,术后跨瓣压差均降至20mmHg以下,无严重并发症发生。无紧急手术及死亡病例。结论:CHD介入治疗具有成功率高、创伤小、并发症及死亡率低等特点,对部分病例可替代外科手术。

Clinical analysis of interventions in 122 patients with congenital heart disease

Clinical analysis of interventions in 122 patients with congenital heart disease ZHANG Li-ting, LIU Wei-qi, HUANG Xuan-sheng, HAN Ying, ZHANG Jing, DENG Zhi-hua, YUAN Yong Department of Cardiology, Zhongshan City People’s Hospital, Guangdong 528403, China Abstract: 【Objective】To evaluate the results of interventions in patients with congenital heart diseases (CHD). 【Methods】Retrospectively analyzed the clinical effects of interventional therapy in consecutive 122 patients with congenital heart disease from January 2000 to September 2007, and the patients distribution including atrial septal defect (ASD) 53 cases, ventricular septal defect (VSD)7 cases, patent ductus arteriosus (PDA) 48 cases, pulmonary stenosis 14 cases. All the interventions were performed via femoral artery and/or vein, and right and left ventriculogram were conducted on all of the patients before and after the procedure. 【Results】120 patients were performed interventional therapy successfully. The technical successful rate was 98.4% (120/122). In the ASD group, 52 patients were occluded successfully. Mild complications were found in 3 cases. 6 patients with VSD were occluded successfully. Only one patient complicated with completed left bundle block. All the 48 patients with PDA were occluded successfully and 7 patients with peripheral vascular complications. All the 14 patients with PS were dilated successfully. After the percutaneous balloon pulmonary valvuloplasty (PBPV), the systolic pressure gradient across pulmonary valve decreased to lower than 20 mm Hg. There were no emergent surgery and patients die in the procedure. 【Conclusion】Interventional therapy of congenital heart disease is characterized with a high successful rate, less invasive, low complication and mortality rate, and it has become promising alternative therapy to surgery in selective patients.