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目的:探讨新型封堵器经胸关闭房间隔缺损的有效性和安全性。方法:设计一种新型的封堵器和传送系统:封堵器由外鞘管、内鞘管、传送杆经第4肋间和右侧房壁送出,封堵房缺。通过这种经胸方式共治疗患者386例,年龄1～79(平均11.8)岁,分析临床资料。结果:房缺平均直径为20.4(4～38)mm,成功植入封堵器382例,因房间隔多发缺损植入2个封堵器22例。整个手术时间为35～62(平均44±7.4)min;术后24h经胸B超证实手术成功率为98.9%;植入术中封堵器脱落1例,因此取出封堵器改用手术方法封闭房缺;另1例患者房缺成功封闭,术后当晚发生颅内出血,经神经外科治疗成功康复。结论:对于大多数房缺患者,经胸封闭房缺是有效且安全的,其操作也较为简便。
Objective: To investigate the effectiveness and safety of the new occluder in transthoracic closure of atrial septal defect. Methods: A new type of occluder and delivery system was designed. The occluder was delivered by the outer sheath, the inner sheath and the delivery rod through the fourth intercostal space and the right side wall to close the atrium. Through this transthoracic treatment of 386 patients, aged 1 to 79 (average 11.8) years of age, clinical data were analyzed. Results: The average size of atrial septal defect was 20.4 (4 ~ 38) mm. 382 occluders were implanted successfully, and 22 occluders were implanted due to atrial septal defect. The total operation time was 35-62 (average 44 ± 7.4) min; the success rate of operation was 98.9% confirmed by ultrasonography at 24 hours after operation; in one case of occlusion of the implant during operation, the occluder was removed and surgically treated Atrial septal defect; another case of atrial septal closure was successful, intracranial hemorrhage occurred the night after surgery, the successful rehabilitation of neurosurgical treatment. Conclusion: For the majority of patients with atrial septal defect, transthoracic closure of the atrium is effective and safe, and its operation is relatively simple.