经导管封堵成人多孔型房间隔缺损的体会

目的:通过对多孔型房间隔缺损(ASD)进行经导管封堵治疗,探讨多孔型ASD介入治疗的适应证及注意事项。 方法:先经心脏超声检查确诊为多孔型ASD,后在局部麻醉下用测量球囊进行试封堵,同时用心脏超声检测试封堵时两ASD闭合情况及孔间距,并确定置入封堵器数量及大小,术后用心脏超声进行随访观察。 结果:全组6例双孔型ASD患者中2例分别置入2个封堵器,4例置入1个封堵器。术后随访1个月至2年,4例无残余分流,1例随访2年虽仍有少许残余分流,但自觉症状好转,心影缩小。另1例术后1个月因残余分流而被迫手术取出。 结论:经导管封堵成人多孔型ASD安全、有效,对两ASD相距较远者应放置2个封堵器,对两ASD相距较近者则可用1个封堵器封堵。

Experience in Transcatheter Closure of Multiple Secundum Atrial Septal Defects in Adults

Objective:To discuss the indications and cautions for transcatheter closure of multiple secundum atrial septal defects(ASD).Methods: All cases were diagnosed as multiple secundum ASD by ultrasound before operation. During the course of trial-occluding with stretched balloon under local anaesthesia, we checked the occlusive condition and distance between two defects by ultrasound, and confirmed the number and size of the occluders. Ultrasound examnitions. Follow-up observation was carried out.Results : Two occluders were implanted in 2 of the 6 patients, and 1 occluder implanted in 4. There was no residual shunt in 4 patients 1 month to 2 years after operation. One patient having small residual shunt at 2-year follow-up had improved symptoms and reduced heart image. The occluder was taken out in the other patient at 1 month after operation because of residual shunt.Conclusion: Transcatheter closure of multiple secundum ASD is safe and efficient. Two occluders are necessary for those 2 ASDs are far apart from each other, and 1 is enough if 2 ASDs are very close.