心脏超声辅助非体外循环下房间隔缺损堵闭术18例

目的 用微创手术方法治疗房间隔缺损及其疗效观察。方法 治疗房间隔缺损患者18例,手术取右胸前外侧切口,于胸骨旁第4肋间切开3 cm长切口,经肋间进胸,切开心包并悬吊,用APACSM房间隔封堵伞,于右心房壁与房间隔缺损对应处缝双荷包线,在右心房荷包线内切开右心房壁,将输送器插入心房内,通过房间隔缺损口直到左心房腔,在食管超声监视下,用推送杆释放出房间隔封堵伞。结果 全部患者手术过程顺利,平均手术时间40分钟,其中平均心内操作10分钟。患者住院5～7日,术后6个月复查,心脏彩超检查堵片无移位,无残余分流。结论 食管超声辅助下房间隔缺损堵闭术是一种微创、安全、确切的治疗方法,病人恢复快,此手术方法有广阔的发展前景。

Minimally invasive closure of atrial septal defect without extracorporeal circulation guidance with echocardiography: report of 18 cases

Objectives To adopt a new kind of minimally invasive operation method to treat the atrial septal defect (ASD). Methods 18 cases with ASD were used the occluder offered with APACSM Hong Kong Co. Ltd., which was directed through a transfer tube into the ASD under view by esophagus echocardiography and corrected the atrial septal defect. Results All patients' operation course was smooth, the time of performing the operation was 40 minutes equally,among them average operation time was 10 minutes. Patient staied in hospital for 5-7 days, all the patients did not exist displayment of occluder and residual shunt by ultrasonic cardiography examination after 6 months. Conclusions The minimally invasive occlusion of ASD by guiding of esophagus echocardiography without extracorporeal circulation is a minimally invasive, safe, precise treatment method for the ASD, there is a wide development prospect in this operation method .