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目的 :评价经导管置入Amplatzer封堵器治疗儿童膜周部室间隔缺损 (perimembraneventricularseptaldefect,PMVSD)的疗效。方法 :5例PMVSD患儿术前均经胸超声心动图确诊 ,术中经左心室造影测量缺损直径 ;所有病例均在透视和经胸超声心动图监视下经导管置入Amplatzer封堵器堵闭PMVSD ;术后 2 4h、1个月、3个月、6个月分别行经胸超声、心电图及X线检查以观察临床疗效。结果 :经左心室造影测量缺损直径为2 .5～ 8.3mm ,平均 (5 .0± 2 .4 )mm ;选用 4～ 10mm ,Amplatzer封堵器堵闭PMVSD ,本组 5例均成功 ,术中未发生任何严重并发症 ;全部患儿术后即刻造影检查示无残余分流 ;术后 2 4h、1、3及 6个月经胸超声心动图检查封堵器位置良好 ,无残余分流 ,心电图检查未发现心律失常 ,X线检查均显示肺血减少。结论 :经导管置入Amplatzer膜部室间隔缺损封堵器治疗PMVSD是一种成功率高、近期疗效可靠的介入方法。
OBJECTIVE: To evaluate the efficacy of transcatheter Amplatzer occluder in the treatment of perimembrane ventriculcular ventricular septal defect (PMVSD) in children. Methods: Five cases of PMVSD were confirmed by thoracic echocardiography preoperatively, and the diameter of the defect was measured by left ventricular angiography. All cases were blocked by Amplatzer occluder under fluoroscopy and transthoracic echocardiography PMVSD; 24 h, 1 month, 3 months and 6 months after operation were performed transthoracic echocardiography, electrocardiogram and X-ray examination respectively to observe the clinical effect. Results: Left ventricular angiography measured the diameter of the defect was 2.5 ~ 8.3mm, with an average of (5.0 ± 2. 4) mm; selected 4 ~ 10mm, Amplatzer occluder closed PMVSD, the group of 5 patients were successful, No serious complications occurred. All the patients had no residual shunt immediately after the operation. After 24 hours, 1, 3 and 6 months after operation, the occluder was well positioned by transthoracic echocardiography with no residual shunt. Electrocardiogram Arrhythmia was not found, X-ray examination showed decreased lung blood. Conclusion: Transcatheter Amplatzer membranous ventricular septal defect occluder for PMVSD is a high success rate, reliable interventional method in the near future.