房间隔瘤并发继发孔型房间隔缺损的介入治疗

目的：评价房间隔瘤（ASA）合并继发孔型房间隔缺损（ASD）介入治疗的安全性和有效性。方法：共19例患者,其中男性7例,女性12例,年龄20-72（43±14.9）岁。经临床症状、胸部X线平片、心电图、经胸超声心动图（TTE）证实为ASA合并Ⅱ孔型ASD,瘤体均凸向右房。测量瘤底直径15-29（21.7±3.9）mm,ASD直径3-28（13.1±6.6）mm。其中单孔型ASD患者14例,2孔型ASD患者2例,多孔型ASD患者3例。空间距离小于7mm1例,大于7mm4例。结果：19例患者中18例一次封堵成功,1例2次封堵成功。技术成功率为100%。封堵器直径14-34（22.1±6.9）mm,所有患者均植入一个封堵器。术后即刻TTE检查穿隔血流消失,ASD完全闭合率为100%。术后1-12个月随访,患者右心房和右心室恢复正常大小17例,2例右房室缩小,无封堵器移位和其他并发症。结论：ASA合并继发孔型ASD介入治疗安全、可行。

Interventional Therapy of Atrial Septal Aneurysm Associated With Secondum Atrial Septal Defect

Objective：To evaluate the safety and efficiency of transactheter closure of atrial septal aneurysm（ASA） associated with secoundum atrial septal defect（ASD）.Methods：We investigated 19 patients,aged from 20 to 72（average： 43±14.9） years old.All patients were diagnosed of ASA associated with ASD by physical examination,X ray and transthoracic echocardiography（TTE）.ASAs were all convexed into right atrial.The largest diameter of ASA was from 15 to 29（average：21.7±3.9） mm,the largest diameter of ASD was from 3 to 28（average： 13.1±6.6）mm.Fourteen cases were single hole ASD,two cases were two hole ASD and 3 cases with multiple holes ASD.One case with the distance between each ASD holes was less than 7mm,and 4 case with the distance between each ASD holes was more than 7 mm.Results：Eighteen cases were successfully occluded just for once,and one case was successfully occluded twice,and the technique success rate was 100%.The sizes of implanting occluders were from 14 to 34（average,22.1±6.9）.All patients were implanted only one occluder to to close ASD hole.Immediately after occlusion,examined by TTE,blood from interseptal was disappear,ASD was completely closed in all 19 cases.During 1-12 months followed up,heart size resumed to normal in 17 cases（89.5%）.Another 2 cases right heart sizes were decreased.None was found occluder shift and other complications.Conclusion：Interventional therapy of ASA associated with ASD is safe and feasible.