国产封堵器治疗室间隔缺损的临床疗效
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摘要
目的探讨国产封堵器介入治疗室间隔缺损(ventricular septal defect,VSD)的临床疗效。方法应用国产封堵器对2014年12月至2017年12月于本院就诊的148例VSD患者行经皮导管封堵手术。结果成功封堵146例(98.6%)。应用对称型室间隔封堵器直径为4～16 mm,偏心型室间隔封堵器直径为6～10 mm,小腰大边型封堵器直径为4～6 mm,另外2例采用动脉导管未闭Amplatzer伞封堵。术后出现并发症有:影响瓣膜启闭1例,封堵器脱落2例,心律失常19例(左束支阻滞8例,间歇性左右束支阻滞1例,完全性右束支阻滞2例,左前分支阻滞2例,室性加速性逸搏心律6例),机械性溶血9例。结论国产封堵器治疗VSD有效、安全,是一项值得推广的微创治疗方法。
Objective To explore the clinical efficacy of transcatheter closure of ventricular septal defect(VSD) using domestic occluders. Methods Between December 2014 and December 2017, a total of 148 patients, who were confirmed VSD in the hospital,underwent transcatheter closure with domestic occluders.Results Occlusion succeeded in 146 cases(98. 6%) using symmetric VSD occluder(range, 4 to 16 mm),eccentric VSD occluder(range, 6 to 10 mm) and small-waist and large-disc one(range, 4 to 6 mm),and 2 cases of patent ductus arteriosus(PDA)used Amplatzer duct occluder. Thirty-one adverse events were reported including 1 case of recurrence of aortic valves,2 cases of occluder falling-off and 19 cases of arrhythmia(8 cases of left bundle branch block, 1 case of intermittent left and right bundle branch block, 2 cases of complete right bundle branch block, 2 cases of left anterior branch block and 6 cases of ventricular accelerated escape rhythm), as well as 9 cases of mechanical hemolysis. ConclusionTranscather closure of VSD with domestic shape occluder is a reliable and safe micro-invasive treatment, which is worth promoting.
Objective To explore the clinical efficacy of transcatheter closure of ventricular septal defect(VSD) using domestic occluders. Methods Between December 2014 and December 2017, a total of 148 patients, who were confirmed VSD in the hospital,underwent transcatheter closure with domestic occluders.Results Occlusion succeeded in 146 cases(98. 6%) using symmetric VSD occluder(range, 4 to 16 mm),eccentric VSD occluder(range, 6 to 10 mm) and small-waist and large-disc one(range, 4 to 6 mm),and 2 cases of patent ductus arteriosus(PDA)used Amplatzer duct occluder. Thirty-one adverse events were reported including 1 case of recurrence of aortic valves,2 cases of occluder falling-off and 19 cases of arrhythmia(8 cases of left bundle branch block, 1 case of intermittent left and right bundle branch block, 2 cases of complete right bundle branch block, 2 cases of left anterior branch block and 6 cases of ventricular accelerated escape rhythm), as well as 9 cases of mechanical hemolysis. ConclusionTranscather closure of VSD with domestic shape occluder is a reliable and safe micro-invasive treatment, which is worth promoting.
引文
[1]Anderson RH,de Leval MR.The morphology of ventricular septal defects as related to the mechanics associated with aortic regurgitation[J].Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu,2006,9:140-146.
[2]Knauth AL,Lock JE,Perry SB,et al.Transcatheter device closure of congenital and postoperative residual ventricular septal defects[J].Circulation,2004,110(5):501-507.
[3]胡楝,曹勇,韦国雄,等.国产封堵器治疗室间隔缺损516例的临床疗效分析[J].岭南心血管病杂志,2017,23(1):59-61.
[4]Demirkol S,Balta S,Cakar M,et al.Which device should be chosen for the percutaneous closure of posttraumatic ventricular septal defects?[J].Clinics,2013,68(3):423.
[5]张亮,张洪梅,王艳东,等.21例膜部室间隔缺损介入封堵并发症临床分析[J].中国实验诊断学,2015,(1):141-142.
[6]Chrysohoou C,Parikh A,Lerakis S.Percutaneous ventricular septal defect closure[J].Cardiovascular Interventions,2016,6(1):119-123.
[7]HijaziZ M,Hakim F,HawelehA A,et a1.Catheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder:initial clinical experience[J].Cathet Cardiovasc Interv,2002,56(4):508-515.
[8]FU YC,BASS J,AMIN Z,et al.Transcatheter closure of perimembranous ventricular septal defects usingthe new Amplatzer membranous VSD occluder:result of the U.S.phase I trial[J].J AmColl Cardiol,2006,47(2):319-325.
[9]张智伟,曾国洪,林曙光,等.国产膜周部室间隔缺损封堵器的研制及临床应用[J].中华心血管病杂志,2005,33(3):228-231.
[2]Knauth AL,Lock JE,Perry SB,et al.Transcatheter device closure of congenital and postoperative residual ventricular septal defects[J].Circulation,2004,110(5):501-507.
[3]胡楝,曹勇,韦国雄,等.国产封堵器治疗室间隔缺损516例的临床疗效分析[J].岭南心血管病杂志,2017,23(1):59-61.
[4]Demirkol S,Balta S,Cakar M,et al.Which device should be chosen for the percutaneous closure of posttraumatic ventricular septal defects?[J].Clinics,2013,68(3):423.
[5]张亮,张洪梅,王艳东,等.21例膜部室间隔缺损介入封堵并发症临床分析[J].中国实验诊断学,2015,(1):141-142.
[6]Chrysohoou C,Parikh A,Lerakis S.Percutaneous ventricular septal defect closure[J].Cardiovascular Interventions,2016,6(1):119-123.
[7]HijaziZ M,Hakim F,HawelehA A,et a1.Catheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder:initial clinical experience[J].Cathet Cardiovasc Interv,2002,56(4):508-515.
[8]FU YC,BASS J,AMIN Z,et al.Transcatheter closure of perimembranous ventricular septal defects usingthe new Amplatzer membranous VSD occluder:result of the U.S.phase I trial[J].J AmColl Cardiol,2006,47(2):319-325.
[9]张智伟,曾国洪,林曙光,等.国产膜周部室间隔缺损封堵器的研制及临床应用[J].中华心血管病杂志,2005,33(3):228-231.