Hu Hai-bo, Jiang Shi-liang, Xu Zhong-ying, Liu Yan-ling, Lü Xiu-zhang, Zhu Zhen-hui, Wang Yun
Department of Radiology, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China.
Zhonghua Yi Xue Za Zhi. 2004 Oct 2;84(19):1592-6.
To evaluate the efficacy of transcatheter closure of perimembranous ventricular septal Defects (VSD) using the new Amplatzer membranous VSD occluder in a short-term follow-up.
From November 2002 to November 2003, forty-eight patients (25 male, 23 female) with perimembranous VSD underwent an attempt of catheter closure using a new device specially designed for the membranous septum. The mean age of patients was 17 years +/- 12 years (ranged from 3 to 48 years); the mean diameter of VSD measured by transthoracic echocardiography (TTE) was 5.1 mm +/- 1.2 mm (ranged from 3 to 12 mm). Occluder was released through right heart system. All patients would undergo follow-up 1 months, 3 months, 6 months and 12 months after procedures with examination of transthoracic echocardiography, radiography, and electrocardiography.
The devices were deployed successfully in 45 patients. there was complete closure in 36 patients immediately, and tiny (< 3 mm) residual shunt in 5 patients. at the follow-up of 3 months, only two of all patients had a tiny residual shunt. Complete left bundle branch block (LBBB) was found in one patients when he was examined in electrocardiograph 2 weeks later, there were no other severe complications. On a follow-up of 1 to 12 months (mean 3.8 months), all patients were demonstrated a great decrease in their left ventricle end-diastolic dimension (LVEDD) (P < 0.05) and no other late complications.
Transcatheter closure of membranous VSD using this new occluder is safe and effective, the results of short-term follow-up was satisfied. Further clinical trials are underway to assess the long-term results.
通过短期随访评估使用新型Amplatzer膜周部室间隔缺损封堵器经导管封堵膜周部室间隔缺损（VSD）的疗效。
2002年11月至2003年11月，48例膜周部VSD患者（男25例，女23例）尝试使用专门为膜周部间隔设计的新型装置进行导管封堵。患者平均年龄为17岁±12岁（3至48岁）；经胸超声心动图（TTE）测量的VSD平均直径为5.1 mm±1.2 mm（3至12 mm）。封堵器经右心系统释放。所有患者在术后1个月、3个月、6个月和12个月接受随访，进行经胸超声心动图、X线摄影和心电图检查。
45例患者封堵器成功植入。36例患者立即完全封堵，5例患者有微小（<3 mm）残余分流。在3个月随访时，所有患者中只有2例有微小残余分流。1例患者在术后2周心电图检查时发现完全性左束支传导阻滞（LBBB），无其他严重并发症。在1至12个月（平均3.8个月）的随访中，所有患者左心室舒张末期内径（LVEDD）均显著减小（P<0.05），无其他晚期并发症。
使用这种新型封堵器经导管封堵膜周部VSD安全有效，短期随访结果满意。正在进行进一步的临床试验以评估长期结果。
