[使用Amplatzer封堵器经导管闭合心肌梗死后室间隔缺损]

[Transcatheter closure of postinfarction ventricular septal defects using Amplatzer devices].

作者信息

Bialkowski Jacek, Szkutnik Malgorzata, Kusa Jacek, Kalarus Zbigniew, Gasior Mariusz, Przybylski Roman, Banaszak Pawel, Zembala Marian

机构信息

Department of Congenital Heart Disease and Pediatric Cardiology, Medical University of Silesia, Silesian Center for Heart Disease, Zabrze, Poland.

出版信息

Rev Esp Cardiol. 2007 May;60(5):548-51.

PMID:17535768

Abstract

We carried out transcatheter procedures to close postinfarction ventricular septal defects (PIVSDs) in 19 patients: two had recanalization after surgical closure, and 17 had a primary PIVSD. In three of the latter patients, who had acute PIVSDs, the procedure was carried out in the first 3 weeks after infarction; in the 13 patients with subacute PIVSD, it was carried out 3.5-12 weeks after infarction. There was another procedure in one patient with chronic PIVSD. In total, 22 procedures were completed: 17 using an Amplatzer atrial septal occluder, two using an Amplatzer postinfarction ventricular septal defect occluder, and two using an Amplatzer muscular ventricular septal defect occluder. The procedure was successful in 14 patients: in 11 with subacute PIVSD, one with chronic PIVSD, and two with postsurgical PIVSD. Transcatheter closure of PIVSDs using an Amplatzer atrial septal occluder is probably the treatment of choice in patients undergoing surgery more than 3.5 weeks after myocardial infarction and in those with recanalization after previous surgical closure.

摘要

我们对19例患者进行了经导管封堵术以关闭心肌梗死后室间隔缺损（PIVSD）：2例在外科手术关闭后出现再通，17例为原发性PIVSD。在后一组患者中，3例为急性PIVSD，手术在心肌梗死后的前3周内进行；13例亚急性PIVSD患者，手术在心肌梗死后3.5 - 12周进行。另有1例慢性PIVSD患者接受了手术。总共完成了22例手术：17例使用Amplatzer房间隔封堵器，2例使用Amplatzer心肌梗死后室间隔缺损封堵器，2例使用Amplatzer肌部室间隔缺损封堵器。14例患者手术成功：11例亚急性PIVSD患者、1例慢性PIVSD患者和2例外科手术后PIVSD患者。对于心肌梗死后超过3.5周接受手术的患者以及先前外科手术关闭后出现再通的患者，使用Amplatzer房间隔封堵器经导管封堵PIVSD可能是首选治疗方法。