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目的 探讨应用Amplatzer封堵器堵闭小儿房间隔缺损 (ASD)的可行性。方法 46例ASD患儿 ,年龄 2～ 15岁 ,平均 (7 5± 4 2 )岁 ,在基础麻醉下 ,先行右心导管用测量球囊导管测量ASD大小 ,选择适合的封堵器 ,在超声指导下放出封堵器堵闭ASD ,然后监测封堵器位置是否满意、有否残余分流、房室瓣有否累及 ,以达到完全堵闭效果。结果 46例全部成功 ,无一例有合并症 ;手术时间 (6 5 88± 2 0 78)min ,透视时间 (11 0 5± 4 0 4)min。结论 经导管AmplatzerASD堵闭术是一种安全、有效的方法 ,适用于 2岁以上、缺损口在 30mm以下的继发孔ASD患儿。但必须严格掌握适应证 ,术中必须应用经胸超声心动图或食道超声帮助提高堵闭术的成功率 ,减少并发症
Objective To investigate the feasibility of using Amplatzer occluder to block ASD in children. Methods 46 children with ASD, aged 2-15 years old, with an average of (75 ± 42) years old, were enrolled in this study. Under basic anesthesia, the right coronary catheter was used to measure the size of ASD with balloon catheter. The suitable occluder was selected. Under the guidance of the occlusion device released blocking ASD, and then monitor the occlusion device position is satisfied, whether residual shunt, atrioventricular valve is involved, in order to achieve complete blocking effect. Results All the 46 cases were successful, and none of them had complications. The operation time was (6588 ± 2 078) min and the time of fluoroscopy was (11 0 ± 4 0 4) min. Conclusions Transcatheter Amplatzer ASD occlusion is a safe and effective method for children with ASD secondary to age 2 and below with a defect of less than 30 mm. But must be strictly controlled indications, intraoperative use of transthoracic echocardiography or esophageal ultrasound to help improve the success rate of occlusion, reduce complications