Hein Ralph, Büscheck Franziska, Fischer Evelyn, Leetz Michaela, Bayard Margareth Taaffe Yves, Ostermayer Stefan, Reschke Madlen, Lang Klaus, Römer Albrecht, Wilson Neil, Sievert Horst
The CardioVascular Center Frankfurt, Sankt Katharinen, Frankfurt, Germany.
J Interv Cardiol. 2005 Dec;18(6):515-22. doi: 10.1111/j.1540-8183.2005.00094.x.
Various transcatheter devices and methods to close congenital heart defects are currently available. Devices have been designed specifically for atrial septal defect (ASD), patent foramen ovale (PFO), and ventricular septal defect (VSD) closure. The trend in interventional treatment of intracardiac shunts shows toward defect-specific systems. The PFO is a tunnel defect requiring occluders that adapt to its length while common ASD strongly vary in their diameter, making a large scale of device sizes indispensable. VSDs are predominantly sealed by coils or tissue-adapted devices like muscular or perimembranous occluders. Since VSDs may occur with an aneurysm (VSA), a multi-perforated septum, an instable myocardial situation (postinfarction) or a high interventricular pressure gradient, closure of these defects is regarded sometimes as complicated. But during the last 30 years (since King and Mills implanted the first double-umbrella occluding system) several studies have proven procedure efficacy and safety of both ASD and VSD closure. This article reviews a large scale of studies and includes our single center data on 1,609 PFO, ASD, and VSD patients.
目前有多种经导管装置和方法可用于闭合先天性心脏缺陷。已专门设计出用于闭合房间隔缺损（ASD）、卵圆孔未闭（PFO）和室间隔缺损（VSD）的装置。心内分流介入治疗的趋势是朝着针对特定缺陷的系统发展。PFO是一种隧道状缺损，需要能适应其长度的封堵器，而常见的ASD在直径上差异很大，因此需要有多种尺寸的装置。VSD主要通过线圈或适合组织的装置（如肌部或膜周部封堵器）进行封堵。由于VSD可能伴有动脉瘤（VSA）、多孔间隔、不稳定的心肌情况（心肌梗死后）或较高的心室间压力梯度，这些缺损的闭合有时被认为很复杂。但在过去30年里（自King和Mills植入首个双伞封堵系统以来），多项研究已证实ASD和VSD闭合手术的有效性和安全性。本文回顾了大量研究，并纳入了我们单中心关于1609例PFO、ASD和VSD患者的数据。
