应用Amplatzer封堵器治疗房间隔缺损和疗效观察

经导管置入Amplatzer封堵器治疗继发孔型房间隔缺损(ASD)，评价其初步疗效。方法5例患者术前经胸超声心动图检查示ASD平均直径14.2mm(7～17mm)，经食管超声心动图(TEE)检查示ASD平均直径13.4mm(6～17mm)，术中用球囊测量ASD伸展径平均17.5mm(7.7～24mm)。患者均在透视及TEE监视下经导管置入Amplatzer封堵器封堵ASD。术后即刻、1天、1、3、6、12个月分别行超声心动图、心电图检查，评价疗效。结果5例封堵器置入均获成功。1例术后随访6个月、3例随访12个月，均无残余分流、血栓栓塞；右室直径由术前的平均32.6mm减少到术后1个月的28.5mm、6个月的24.7mm、12个月的24.5mm。结论经导管置入Amplatzer封堵器治疗继发孔房间隔缺损是操作简便、患者创伤小、安全、有效的方法。

EVALUATION OF TREATMENTFOR SECUNDUM ATRIALSEPTAL DEFECTS BY AMPLATZER SEPTAL OCCLUDER

To assess the efficacy and initial results of transcatheter closure of secundum atrial septal defects(ASD) using Amplatzer septal occluder(ASO). Methods:Five patients aged 17～48 years old were enrolled. Before intervention, transthoracic (TTE) and transesophageal (TEE) color Doppler echocardiography had done for all patients. The average diameter of ASD was 14.2mm(7～17mm) by TTE and 13.4mm(6～17mm)by TEE, respectively. The average balloon stretched diameter of ASD was 17.5mm(7.7～24mm). All cases were treated by ASO through percutaneous procedure. The procedures were carried out under the guiding of fluoroscopy and TEE. TTE or TEE and ECG were done immediately,24 hours, 1,3,6 and 12months after the procedure to assess the efficacy and complications. Results: The ASOs were successfully implanted in all 5 patients. One case completed 6 months and 3 cases completed 12 months follow-up. There were no residual shunts.The right ventricle diameter was reduced from 32.6mm before intervention to 28.5mm,24.7mm and 24.5mmafter 1,6 and 12 months' intervention, respectively. Conclusion:Amplatzer septal occluder is an efficient and safe device for transcatheter closure of secundum ASD.