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目的 研究Amplatzer导管封堵器 (ADO)介入闭合先天性膜周部室间隔缺损 (VSD)的可行性、安全性和有效性 ,确定其适应证和并发症。方法 2 0 0 1年 5月至 2 0 0 2年 1 2月 ,经导管闭合先天性膜周部VSD 4 1例 ,VSD直径 4～ 1 2 .8(平均 6 .0 )mm ,其上缘距离主动脉右冠瓣 4 .5～ 1 2 (平均 6 .6 )mm。心导管资料示QP/QS 1 .4～ 2 .6 (平均 1 .7) ,肺动脉收缩压 1 9～ 34(平均 2 5 )mmHg。 4 1例膜周部VSD中 ,1 8例伴有膜部膨出瘤。结果 4 1例VSD均顺利闭合成功 ,选用的ADO尺寸为 6 / 4～ 1 6 /1 4mm。术后心脏杂音立即消失 ,选择性左心室造影及经胸超声心动图均无明显残余分流。胸片示肺血管影较术前减少。心电图有 1 2例出现不完全性右束支传导阻滞 ,1例出现完全性左束支传导阻滞 ,均在 1～ 2周内自行消失。随访 2～ 2 1个月 ,临床及实验室资料进一步改善 ,未见ADO移位、主动脉瓣或三尖瓣返流及其他并发症。结论 用ADO介入闭合先天性膜周部VSD是完全可行的 ,而且具有操作简便、安全高效、并发症少和费用较低等优点
Objective To investigate the feasibility, safety and efficacy of Amplatzer catheter occluder (ADO) in the treatment of closed congenital peritoneal membrane septal defect (VSD) and to determine the indications and complications. Methods From May 2001 to January 2012, 1 case of VSD 4 was closed by catheterization, and the diameter of VSD was 4 ~ 12.8 (average 6. 0) mm. The upper margin From the right aortic coronary artery flap 4.5 ~ 12 (average 6.6) mm. Cardiac catheterization showed QP / QS 1.4 ~ 2.6 (mean 1.7) and pulmonary systolic pressure 19-34 (mean 25) mmHg. Among the 41 cases of peritumoral VSD, 18 cases had membranous bulging tumor. Results All 4 cases of VSD successfully closed successfully. The size of ADO used was 6/4 ~ 16/14 mm. Immediately after the heart murmur disappeared, selective left ventricular angiography and transthoracic echocardiography showed no significant residual shunt. Chest radiograph showed decreased pulmonary vascular preoperatively. 12 cases of ECG incomplete right bundle branch block, a case of complete left bundle branch block, all within 1 to 2 weeks disappear. Followed up for 2 ~ 21 months, clinical and laboratory data to further improve, no ADO shift, aortic valve or tricuspid regurgitation and other complications. Conclusion It is feasible to use ADO to close the congenital peritoneal VSD, and it has the advantages of simple operation, safe and efficient, less complications and lower cost