Rossi Raul I, Cardoso Cristiano de Oliveira, Machado Paulo Renato, Francois Lisia Galant, Horowitz Estela Suzana K, Sarmento-Leite Rogerio
Department of Interventional Cardiology, Institute of Cardiology of Rio Grande Do Sul, Porto Alegre-RS, Brazil.
Catheter Cardiovasc Interv. 2008 Feb 1;71(2):231-6. doi: 10.1002/ccd.21361.
To analyze the efficacy and follow-up results of percutaneous closure of Atrial septal defect (ASD) with the Amplatzer septal occluder in children aged <10 years old.
Between November 1998 and September 2005, 27 patients diagnosed with ASD were treated percutaneously with an Amplatzer septal occluder. The procedure was carried out in the cathlab, under general anesthesia and with both fluoroscopy and transesophageal echocardiography guidance. Basal physical examinations and echocardiograms were performed prior to the procedure and at 30 days, 6, and 12 months of follow-up. Survival free of symptom was estimated by Kaplan-Meier.
The mean age, weight, height, body mass index, and corporal surface was: 5.35 +/- 2.11 years, 23.07 +/- 9.43 kg, 110.55 +/- 17.6 cm, 16.77 +/- 2.42 kg/m(2), and 1.24 +/- 2.44 m(2). The prevalence of septal aneurysm was 3.7% and all patients presented single secundum ASD. The mean stretched diameter by fluoroscopy and transesophageal echocardiography were 17.18 +/- 6.75 mm and 16.77 +/- 5.99 mm, and the prostheses sizes were 18.83 +/- 6.98 mm, ranging from 10 to 30 mm. The systolic and diastolic pulmonary pressures were 25.26 +/- 5.97 mm Hg and 13.38 +/- 3.40 mm Hg, respectively. The procedure time was 82.92 +/- 29.14 min and the hospital stay was 2.20 +/- 0.26 days. Clinical and echocardiography follow-ups were performed within 11.59 +/- 4.42 months and all devices were in the correct position with no residual shunt. Right ventricular diameter decreased from 19.38 +/- 5.23mm to 11.38 +/- 11.92 (P 0.001). No major complications or deaths occurred; two patients had a hematoma at the vascular access.
Secundum atrial septal defect closure can be safely and successfully performed with the Amplatzer septal occluder in children younger than 10 years old.
分析应用Amplatzer房间隔封堵器经皮闭合10岁以下儿童房间隔缺损（ASD）的疗效及随访结果。
1998年11月至2005年9月，27例诊断为ASD的患者应用Amplatzer房间隔封堵器行经皮治疗。手术在导管室进行，全身麻醉，在荧光透视和经食管超声心动图引导下操作。术前及术后30天、6个月和12个月进行基础体格检查和超声心动图检查。采用Kaplan-Meier法评估无症状生存率。
平均年龄、体重、身高、体重指数和体表面积分别为：5.35±2.11岁、23.07±9.43kg、110.55±17.6cm、16.77±2.42kg/m²和1.24±2.44m²。房间隔瘤的发生率为3.7%，所有患者均为单纯继发孔型ASD。荧光透视和经食管超声心动图测得的平均伸展直径分别为17.18±6.75mm和16.77±5.99mm，封堵器大小为18.83±6.98mm，范围为10至30mm。收缩期和舒张期肺动脉压分别为25.26±5.97mmHg和13.38±3.40mmHg。手术时间为82.92±29.14分钟，住院时间为2.20±0.26天。在11.59±4.42个月内进行了临床和超声心动图随访，所有封堵器位置正确，无残余分流。右心室直径从19.38±5.23mm降至11.38±11.92（P<0.001）。无重大并发症或死亡发生；2例患者血管穿刺处出现血肿。
应用Amplatzer房间隔封堵器可安全、成功地闭合10岁以下儿童的继发孔型房间隔缺损。
