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目的回顾性总结伴膜部瘤的室间隔缺损(VSD)介入治疗病例,对如何选择封堵器的型号和安放位置进行分析,以期促进室间隔缺损介入治疗的进一步规范。方法对2004年5月至2005年5月入院治疗的伴膜部瘤形成的室间隔缺损患儿进行造影、超声和介入过程分析。测量膜部瘤的7条径线,并与封堵器型号和封堵位置进行归纳,寻找可能的选择规律。结果35例患儿被纳入研究。VSDs直径为2．7～11．9 mm,平均(6．4±2．6)mm。膜部瘤的破口最大径为1．5～4．1 mm,平均(2．9±0．9)mm。VSDs边缘距主动脉瓣距离为2～7mm,平均(4．3±1．7)mm。32例介入治疗手术成功。封堵器采用双侧对称伞,从4～14 mm不等。封堵器左室盘封堵缺损左室面者29例、封堵膜部瘤破口左侧者3例。结论封堵器左室盘放置位置取决于右室盘能否在右心室侧复型。首选位置是缺损的左心室面。当右室盘不能正常复型时,可选择在膜部瘤破口左侧放置左室盘。封堵器型号选择应根据封堵器安放位置决定。在左心室面释放左室盘,一般选择型号与左室面直径相等或大1～2 mm。在膜部瘤破口左侧释放左室盘时,如果为单破口型,选择同上；如果为多破口型,选择能遮盖相距最远的两破口间距离的最小封堵器。
Objective To retrospectively summarize the interventional treatment of ventricular septal defect (VSD) in patients with meningioma and to analyze how to select the type and placement of occluder in order to promote the further specification of interventional treatment of ventricular septal defect. Methods We analyzed the imaging, ultrasonography and interventional procedures of children with ventricular septal defect who were admitted to hospital from May 2004 to May 2005. Measurement of membranous neoplasm 7 radial lines, and the occluder model and the location of closure summarized, looking for possible selection rules. Results 35 cases were included in the study. VSDs ranged from 2.7 to 11.9 mm in diameter with an average of (6.4 ± 2.6) mm. Membranous neoplasm breach maximum diameter of 1.5 ~ 4.1 mm, with an average (2.9 ± 0.9) mm. The distance between VSDs and the aortic valve was 2 ~ 7mm, with an average of (4.3 ± 1.7) mm. 32 cases of successful interventional surgery. Occluder uses bilateral symmetrical umbrella, ranging from 4 to 14 mm. Left ventricular occluder occlusion of the left ventricular surface in 29 cases of patients, blocking membrane tumor in the left side of the tumor in 3 cases. Conclusion The location of the occluder left ventricle depends on whether the right ventricle can be reconstructed in the right ventricle. The preferred location is the defect of the left ventricular surface. When the right ventricular disk can not be normal complex type, you can choose to place in the left side of the membrane tumor rupture left ventricular disk. Occluder model selection should be based on the location of the occluder placement. In the left ventricular surface release of left ventricular disk, the general model of choice and left ventricular surface diameter equal to or 1 ~ 2 mm. In the left part of the membrane aneurysm rupture of the left ventricular release plate, if the single-break type, select the same as above; if it is more broken type, select to cover the farthest distance between the two breakers minimum occluder.