Kaya Mehmet Güngör, Ozdoğru Ibrahim, Baykan Ali, Doğan Ali, Inanç Tuğrul, Doğdu Orhan, Uzüm Kazim, Narin Nazmi, Topsakal Ramazan, Ergin Ali, Oğuzhan Abdurrahman, Eryol Namik Kemal
Erciyes Universitese Tip Fakültesi, Kardiyoloji Anabilim Dali, Kayseri, Turkey.
Turk Kardiyol Dern Ars. 2008 Jul;36(5):287-93.
We evaluated short-term results of transcatheter closure of secundum atrial septal defects (ASD) with the Amplatzer septal occluder (ASO) in adults.
The study included 12 patients (6 males, 6 females; mean age 31+/-9 years; range 17 to 54 years) who underwent transcatheter ASD closure with the ASO device. Prior to the procedure, the mean pulmonary to systemic flow ratio was 1.9+/-0.3 (range 1.5 to 2.6). The mean ASD diameter measured by transesophageal echocardiography was 13.9+/-2.8 mm, the mean stretched diameter of ASD measured by balloon sizing was 15.8+/-3.4 mm, and the mean ASO device diameter was 17.3+/-4.7 mm. The patients were evaluated before and six months after the procedure by echocardiography, electrocardiography, and the New York Heart Association (NYHA) functional classification.
Transcatheter ASD closure was successfully performed in 11 patients (91.7%). The mean procedure time was 72 minutes. There was no residual shunt at six months after closure. No serious complications occurred during the procedure and within a mean follow-up of 11.6+/-2.3 months. Echocardiographic examination at six months showed significant decreases in right ventricular end-diastolic diameter (VEDD) (p=0.007), right/left VEDD ratio (0.003), systolic pulmonary artery pressure (p=0.017), and significant increases in left ventricular ejection fraction (p=0.014) and left VEDD (p=0.005). There were significant decreases in maximum (p=0.003) and minimum (p=0.006) P-wave durations, and P-wave dispersion (p=0.028). The NYHA functional capacity improved significantly from 1.8+/-0.8 to 1.3+/-0.5 (p=0.014).
Transcatheter closure of secundum ASD with the ASO device is a safe and effective method in adult patients, resulting in significant improvement in clinical symptoms and cardiac dimensions.
我们评估了使用Amplatzer房间隔封堵器（ASO）对成人继发孔型房间隔缺损（ASD）进行经导管封堵的短期效果。
该研究纳入了12例患者（6例男性，6例女性；平均年龄31±9岁；范围17至54岁），这些患者接受了使用ASO装置的经导管ASD封堵术。术前，平均肺循环与体循环血流量之比为1.9±0.3（范围1.5至2.6）。经食管超声心动图测量的平均ASD直径为13.9±2.8mm，球囊扩张测量的ASD平均伸展直径为15.8±3.4mm，ASO装置平均直径为17.3±4.7mm。在术前及术后6个月通过超声心动图、心电图和纽约心脏协会（NYHA）功能分级对患者进行评估。
11例患者（91.7%）成功完成经导管ASD封堵。平均手术时间为72分钟。封堵术后6个月无残余分流。手术过程中及平均11.6±2.3个月的随访期内未发生严重并发症。术后6个月的超声心动图检查显示右心室舒张末期内径（VEDD）显著减小（p = 0.007），右/左VEDD比值减小（0.003），收缩期肺动脉压降低（p = 0.017），左心室射血分数显著增加（p = 0.014），左VEDD增加（p = 0.005）。最大（p = 0.003）和最小（p = 0.006）P波时限以及P波离散度显著降低（p = 0.028）。NYHA功能能力从1.8±0.8显著改善至1.3±0.5（p = 0.014）。
使用ASO装置经导管封堵继发孔型ASD对成人患者是一种安全有效的方法，可使临床症状和心脏大小得到显著改善。
