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目的:探讨应用双封堵器对复杂膜部瘤型室间隔缺损(VSD)进行介入封堵治疗的可行性、有效性和安全性。方法:12例复杂膜部瘤型VSD患者,左心室造影后常规右股动脉-左心室-VSD-右心室-右股静脉输送轨道,对VSD进行封堵,重复左心室造影,发现存在不能接受的残余分流,遂建立右股动脉-左心室-VSD-右心室-左股静脉输送轨道,应用第2枚封堵器对残余分流进行封堵,左心室、升主动脉造影以及超声心动图检查确认封堵效果良好,释放封堵器。术后1、3、6、12个月复查超声心动图、X线检查和12导联心电图。结果:12例患者均封堵成功。术毕即刻造影和超声心动图检查示封堵效果良好,无残余分流,各组瓣膜功能良好,无并发症发生。随访期间所有患者杂音消失,超声心动图检查无残余分流,心电图检查均为窦性心律,无房室传导阻滞或束支传导阻滞。结论:应用双封堵器对复杂膜部瘤型VSD进行封堵治疗是可行的,且具有满意的疗效和安全性。
Objective: To investigate the feasibility, effectiveness and safety of double occluder for interventional occlusion of complex membranous ventricular septal defect (VSD). Methods: Twelve patients with complicated membranous neoplasm type VSD were involved in conventional right femoral artery-left ventricle-VSD-right ventricle-right femoral vein after left ventricular angiography. The VSD was occluded and repeated left ventricular angiography was performed, and found to be unacceptable Of the residual shunt, then the right femoral artery - left ventricle - VSD - right ventricle - left femoral vein orbit, the second occluder occlusion residual shunt, left ventricular, ascending aorta angiography and echocardiography Confirm the sealing effect is good, release occluder. Echocardiography, X-ray examination and 12-lead electrocardiogram were performed at 1, 3, 6 and 12 months after operation. Results: All 12 patients were successfully blocked. Intraoperative angiography and echocardiography showed good occlusion, no residual shunt, each valve function well, no complications. During follow-up all patients with murmur disappeared echocardiography without residual shunt, ECG were sinus rhythm, no atrioventricular block or bundle branch block. Conclusion: It is feasible to use double occluder to occlude complex membranous neovascular VSDs with satisfactory curative effect and safety.