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使用戈尔(®)间隔封堵器经导管封堵卵圆孔未闭:早期和中期临床结果

Transcatheter PFO closure with GORE(®) septal occluder: early and mid-term clinical results.

作者信息

Butera Gianfranco, Saracino Antonio, Danna Paolo, Sganzerla Paolo, Chessa Massimo, Carminati Mario

机构信息

Department of Pediatric Cardiology and GUCH Unit, Policlinico San Donato IRCCS, Milan, Italy.

出版信息

Catheter Cardiovasc Interv. 2013 Nov 15;82(6):944-9. doi: 10.1002/ccd.25106. Epub 2013 Jul 30.

Abstract

BACKGROUND

Transcatheter closure of patent foramen ovale (PFO) is a widespread procedure. However the "quest" for the ideal device is still ongoing. Here we present the procedural and early results of transcatheter closure of PFO with the GORE® Septal Occluder.

METHODS

Three Italian centers participated in a registry and collected data from 122 consecutive patients undergoing PFO closure by using GSO device. Indication for closure was previous stroke or transient cerebral ischemia in 110 and migraine in 12 subjects.

RESULTS

The procedure was successful in all patients. The procedure was performed under general anesthesia, fluoroscopic, and trans-esophageal echocardiographic imaging in 80 subjects while it was performed with local anesthesia, fluoroscopic, and intracardiac echocardiographic monitoring in 42 subjects. Twenty patients received a 20 mm device, 70 patients received a 25 mm device, and 32 received a 30 mm device. Procedure and fluoroscopy times were 30 ± 20 and 5 ± 4 min, respectively. In three cases, the implanted device was retrieved because of unsatisfactory position. Four subjects (2.5%) experienced vascular complications. During a median follow-up of 9 months (range 1-18 months) seven patients experienced atrial arrhythmias and four of them required medical treatment. At six months follow-up, at chest X-ray in two cases there was evidence of fracture of two wires of the device. Devices were stable and no treatment was required. Moderate residual shunting was found in two patients at 6- and 12-months follow-up. No other complication occurred.

CONCLUSION

GORE® Septal Occluder is an easy, safe, and effective device in closing PFO.

摘要

背景

经导管闭合卵圆孔未闭(PFO)是一种广泛应用的手术。然而,对理想器械的“探索”仍在继续。在此,我们展示使用GORE®房间隔封堵器经导管闭合PFO的手术过程及早期结果。

方法

三个意大利中心参与了一项注册研究,并收集了122例连续使用GSO器械进行PFO闭合的患者的数据。闭合的指征为既往有卒中或短暂性脑缺血发作的患者110例,偏头痛患者12例。

结果

所有患者手术均成功。80例患者在全身麻醉、荧光透视和经食管超声心动图成像下进行手术,42例患者在局部麻醉、荧光透视和心腔内超声心动图监测下进行手术。20例患者使用20mm的器械,70例患者使用25mm的器械,32例患者使用30mm的器械。手术时间和透视时间分别为30±20分钟和5±4分钟。3例患者因位置不满意取出植入的器械。4例患者(2.5%)发生血管并发症。在中位随访9个月(范围1 - 18个月)期间,7例患者出现房性心律失常,其中4例需要药物治疗。在6个月随访时,胸部X线检查发现2例患者器械的两根金属丝有断裂迹象。器械稳定,无需治疗。在6个月和12个月随访时,2例患者发现有中度残余分流。未发生其他并发症。

结论

GORE®房间隔封堵器是一种用于闭合PFO的简便、安全且有效的器械。

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