Munayer Calderón Jaime E, Zabal Cerdeira Carlos, Lázaro Castillo José Luis, Maza Juárez Gerardo, San Luis Miranda Raúl, Aldana Pérez Tomás, Ramírez Reyes Homero, Amaya Hernández Antonio, Espinola Nilda
Departamento de Hemodinamia, Hospital General CMN, La Raza.
Arch Cardiol Mex. 2002 Jan-Mar;72(1):53-7.
We performed transcatheter closure of an atrial septal defect (ASD) using an Amplatzer device in three patients, 2 women and 1 male child, aged 12, 54, and 4 years, respectively, coursing with ostium secundum ASD. Two with left to right shunt and the third with bidirectional shunt. The transesophageal echocardiogram revealed ASD with diameters of 13, 15, and 10 mm, the diameter with expanded catheter balloon was of 30, 26, and 17 mm, respectively. The superior border of the atrial septum was bigger than 5 mm in all three patients, whereas the inferior border could not be found through echocardiography in the patients aged 12 and 4 years. Amplatzer devices of 30, 26, and 17 mm were implanted, the inferior border of the first two could be supported on the aortic wall and the superior border on the septum. We observed a 100% occlusion in these two cases through ecocolor-Doppler. In the third patient, an inferior border of 16 mm and a superior border of 8 mm were determined, achieving and immediate and fast installation of the device with 100% occlusion. All three patients were in stable conditions, asymptomatic and without shunt at their one-month follow-up as revealed by a trans-thoracic echocardiography. It is concluded that the Amplatzer device is technically easy to install and yields adequate results even in patients with ample ASD and without inferior border of the inter-atrial septum.
我们使用Amplatzer封堵器对3例房间隔缺损(ASD)患者进行了经导管封堵,其中2例女性,1例男性儿童,年龄分别为12岁、54岁和4岁,均为继发孔型ASD。2例为左向右分流,第3例为双向分流。经食管超声心动图显示ASD直径分别为13 mm、15 mm和10 mm,扩张后的导管球囊直径分别为30 mm、26 mm和17 mm。所有3例患者房间隔上缘均大于5 mm,而12岁和4岁患者经超声心动图未发现下缘。分别植入了30 mm、26 mm和17 mm的Amplatzer封堵器,前两者的下缘可支撑在主动脉壁上,上缘支撑在房间隔上。通过彩色多普勒超声,我们观察到这2例患者封堵率达100%。在第3例患者中,确定下缘为16 mm,上缘为8 mm,装置即刻快速植入,封堵率达100%。所有3例患者情况稳定,无症状,经胸超声心动图显示1个月随访时无分流。结论是,即使对于缺损较大且房间隔无下缘的患者,Amplatzer封堵器在技术上易于植入且效果良好。