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经导管房间隔缺损封堵术:即刻及中期结果。

Device closure of atrial septal defect: immediate and mid-term results.

机构信息

Department of Cardiology, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.

出版信息

Circ J. 2012;76(5):1229-34. doi: 10.1253/circj.cj-11-1379. Epub 2012 Feb 16.

Abstract

BACKGROUND

Transcatheter closure of atrial septal defects (ASDs) has become an alternative to open surgical procedures. The Amplatzer septal occluder (ASO) has been approved since 2005 in Japan, but there are still many concerns about adverse events, and information about outcomes and complications is limited. The objective of this study was to assess the immediate and mid-term outcomes of device closure of secundum ASDs.

METHODS AND RESULTS

From August 2005 to July 2011, 208 consecutive patients with a significant secundum ASD underwent percutaneous closure with the ASO [72 males, 136 females; median age, 7.3 years (range, 3.3-21.9 years)]. Follow-up was available for 206 (99%) patients. Device closure was successful in 203 (98%) patients. Device embolization occurred in 1 case within 1h of device implantation, but the device was surgically retrieved without any neurological sequelae. During the follow-up period, complete closure was observed in 202 of 203 patients. There were no cases of erosions, late embolization, thrombus formation, or death.

CONCLUSIONS

Transcatheter closure of ASDs using the ASO is safe and effective, with excellent results during mid-term follow-up. Appropriate patient selection and accurate device selection is mandatory to avoid serious complications.

摘要

背景

经导管封堵房间隔缺损(ASD)已成为一种替代开胸手术的方法。Amplatzer 房间隔封堵器(ASO)自 2005 年在日本获准使用,但仍有许多人对不良事件表示担忧,而且有关结果和并发症的信息有限。本研究旨在评估经皮 ASD 封堵术即刻和中期的结果。

方法和结果

2005 年 8 月至 2011 年 7 月,208 例继发孔型 ASD 患者采用 ASO 行介入封堵术[72 例男性,136 例女性;中位年龄为 7.3 岁(范围:3.3-21.9 岁)]。206 例(99%)患者获得了随访。203 例(98%)患者封堵器成功植入。1 例患者在植入封堵器后 1 小时内发生封堵器栓塞,但未出现任何神经后遗症而通过手术取出。在随访期间,202 例患者(203 例中的 98%)观察到完全封堵。无侵蚀、晚期栓塞、血栓形成或死亡发生。

结论

采用 ASO 行经导管 ASD 封堵术安全有效,中期随访结果良好。为避免严重并发症,必须进行适当的患者选择和准确的器械选择。

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