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目的探讨国产偏心型封堵器介入治疗室间隔缺损的临床疗效。方法2006年3月—2008年8月,46室间隔缺损患者使用国产偏心型封堵器,其中21例为膜周型室间隔缺损,18例为嵴下型室间隔缺损,7例为嵴内型室间隔缺损,经胸超声心动图提示室间隔缺损(VSD)的直径为4～10mm,术中行左室造影、建立股动静脉轨道、经右心系统释放封堵器,并分别于术后2周、1个月、3个月、6个月进行随访。结果46例中43例封堵器均成功置入。1例术中封堵器影响主动脉瓣,2例出现较大残余分流而放弃介入改开胸手术,3例术后造影存在微量至少量残余分流,6个月后行超声检查分流消失。结论经导管植入国产偏心封堵器治疗VSD是一种安全有效的微创介入治疗方法,操作简便,成功率高,近期疗效可靠。
Objective To investigate the clinical effect of domestic eccentric occluder interventional treatment of ventricular septal defect. Methods From March 2006 to August 2008,46 patients with ventricular septal defect were treated with eccentric occluder made in China. Twenty-one of them were perimembranous ventricular septal defect, 18 were subclavian ventricular septal defect and seven were intracristal Transeptal septal defect, transthoracic echocardiography prompted ventricular septal defect (VSD) diameter of 4 ~ 10mm, intraoperative left ventricular angiography, the establishment of femoral venous orbit, the release of the occluder via the right heart and postoperative 2 weeks, 1 month, 3 months, 6 months follow-up. Results 46 cases of occluder in 43 cases were successfully inserted. In one case, the occluder affected the aortic valve, two cases had large remnant shunt, and the interventional change thoracotomy was abandoned. Three cases had minimal residual shunt after operation and six months later the shunt disappeared. Conclusion Transcatheter implantation of domestic eccentric occluder for the treatment of VSD is a safe and effective minimally invasive interventional treatment method, which is simple and convenient to operate with high success rate and reliable curative effect in the near future.