Godart F, Rey C, Francart C, Cajot M A, Brevière G M, Vaksmann G, Devos P, Coullet J M, Vincentelli A
Service des Maladies Cardio-vasculaires Infantiles et Congénitales, Hôpital Cardiologique, Centre Hospitalier et Universitaire de Lille, France.
Cardiol Young. 2000 Sep;10(5):527-33. doi: 10.1017/s1047951100008222.
We report our experience using the buttoned device to close defects within the oval fossa and probe-patent oval foramens, comparing the findings with those obtained with the Amplatzer septal occluder. From 1992 to 1997, we used the buttoned device to close defects in 73 consecutive patients, 64 with defects in the oval fossa and nine with patent foramens. We compared this experience with a further series of 62 patients seen from 1997 to 1999 in whom the Amplatzer septal occluder was used. Successful implantation was achieved in three-quarters of those with septal defects in whom the buttoned device was used, in all of those in whom the buttoned device was used for patent foramens, and in nine-tenths of those in whom closure was attempted using the Amplatzer occluder. Immediate surgery was needed in 3 patients in whom a buttoned device was used, one because of embolization and two with residual shunts and a straddling device. Similar immediate surgery was needed to retrieve one embolized Amplatzer occluder. During follow-up, surgery was needed in a further 7 patients, all having had insertion of a buttoned device, because of atrial perforation in one and a significant residual shunt in the remainder. At late follow-up, the rate of complete occlusion was 69% in the patients in whom the buttoned device was used to close a septal defect, 100% when the buttoned device was used for patent foramens, and 95% in those treated with the Amplatzer occluder. Our experience shows that the Amplatzer occluder produced a significantly higher rate of occlusion for larger defects, and with a shorter fluoroscopy time than the buttoned device. The Amplatzer septal occluder, therefore, is our preferred device for closure of defects within the oval fossa.
我们报告了使用纽扣式装置闭合卵圆窝内缺损及卵圆孔未闭的经验，并将结果与使用Amplatzer房间隔封堵器的情况进行比较。1992年至1997年，我们连续对73例患者使用纽扣式装置闭合缺损，其中64例为卵圆窝缺损，9例为卵圆孔未闭。我们将这一经验与1997年至1999年使用Amplatzer房间隔封堵器的另外62例患者的情况进行比较。使用纽扣式装置的房间隔缺损患者中有四分之三成功植入，使用纽扣式装置治疗卵圆孔未闭的患者全部成功植入，而尝试使用Amplatzer封堵器闭合缺损的患者中有十分之九成功植入。使用纽扣式装置的3例患者需要立即手术，1例因栓塞，2例有残余分流且封堵器跨立。取出1例栓塞的Amplatzer封堵器也需要进行类似的立即手术。随访期间，另外7例患者需要手术，这些患者均植入了纽扣式装置，1例因心房穿孔，其余因明显残余分流。在后期随访中，使用纽扣式装置闭合房间隔缺损的患者完全封堵率为69%，使用纽扣式装置治疗卵圆孔未闭的患者为100%，使用Amplatzer封堵器治疗的患者为95%。我们的经验表明，对于较大缺损，Amplatzer封堵器的封堵率明显更高，且透视时间比纽扣式装置短。因此，Amplatzer房间隔封堵器是我们闭合卵圆窝内缺损的首选装置。
