成人经导管封堵多发性房间隔缺损的临床疗效及安全性分析

Clinical efficiency and safety analysis of transcatheter closure of multiple atrial septal defects in adults.

作者信息

Song Zhi-Yuan, He Guo-Xiang, Shu Mao-Qin, Hu Hou-Yuan, Tong Shi-Fei, Ran Bo-Li, Liu Jian-Ping, Li Yong-Hua, Jing Tao

机构信息

Department of Cardiology, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.

出版信息

Clin Cardiol. 2009 Mar;32(3):130-4. doi: 10.1002/clc.20450.

DOI:10.1002/clc.20450

PMID:19301294

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6653734/

Abstract

BACKGROUND

Transcatheter closure of atrial septal defects (ASDs) is currently a reliable alternative to surgery, even though challenging in patients with multiple ASDs.

HYPOTHESIS

The aim of this study was to evaluate the clinical efficiency and safety of transcatheter closure in multiple ASDs.

METHODS

Multiple ASDs were diagnosed by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The occlusive condition and distance between 2 adjacent ASDs were measured by TTE examination. Then, the number and size of the occluder(s) was determined. TTE examinations were performed after transcatheter closure as follow-up.

RESULTS

The transcatheter procedure was successful in 15 patients with multiple ASDs, using a single occluder in 9 patients and 2 occluders in the remaining 6 patients. Overall, 21 ASD occluders were implanted. During a follow-up period of 6 mo to 5 y, a slight residual shunt was found in 1 patient without any symptoms; a moderate residual shunt was identified at the inferior vena cava and the occluder was removed by surgery 1 mo after procedure. Other complications, including endocarditis, arrhythmia, thromboembolism, and atrioventricular valve damage were not recorded in any of the 15 patients during the follow-up period.

CONCLUSION

Transcatheter closure of multiple ASDs is safe and efficient. Two occluders are necessary for the distance of 2 ASDs more than 7 mm, and a single occluder is sufficient for those 7 mm or less.

摘要

背景

经导管封堵房间隔缺损（ASD）目前是一种可靠的手术替代方法，尽管对于患有多个ASD的患者具有挑战性。

假设

本研究的目的是评估经导管封堵多个ASD的临床有效性和安全性。

方法

通过经胸超声心动图（TTE）或经食管超声心动图（TEE）诊断多个ASD。通过TTE检查测量2个相邻ASD之间的封堵情况和距离。然后，确定封堵器的数量和尺寸。经导管封堵后进行TTE检查作为随访。

结果

15例患有多个ASD的患者经导管手术成功，9例患者使用单个封堵器，其余6例患者使用2个封堵器。总体而言，共植入了21个ASD封堵器。在6个月至5年的随访期内，1例患者发现轻微残余分流，无任何症状；在下腔静脉发现中度残余分流，术后1个月通过手术取出封堵器。在随访期间，15例患者中均未记录到其他并发症，包括心内膜炎、心律失常、血栓栓塞和房室瓣损伤。