Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea.
Yonsei Med J. 2013 Sep;54(5):1104-9. doi: 10.3349/ymj.2013.54.5.1104.
For the successful completion of transcatheter closure of atrial septal defects with the Amplatzer septal occluder, shape of the defects should be considered prior to selecting the device. The purpose of this study is to evaluate the results of a transcatheter closure of oval shaped atrial septal defect.
From November 2009 until November 2011, cardiac computed tomography was performed on 69 patients who needed a transcatheter closure of atrial septal defect. We defined an oval shaped atrial septal defect as the ratio of the shortest diameter to the longest diameter ≤ 0.75 measured using computed tomography. A trans-thoracic echocardiogram was performed one day after and six months after.
The transcatheter closure of atrial septal defect was performed successfully in 24 patients in the ovoid group and 45 patients in the circular group. There were no serious complications in both groups and the complete closure rate at 6 months later was 92.3% in the ovoid group and 93.1% in the circular group (p>0.05). The differences between the device size to the longest diameter of the defect and the ratios of the device size to the longest diameter were significantly smaller in the ovoid group (1.8 ± 2.8 vs. 3.7 ± 2.6 and 1.1 ± 0.1 vs. 1.2 ± 0.2).
Transcatheter closure of an oval shaped atrial septal defect was found to be safe with the smaller Amplatzer septal occluder device when compared with circular atrial septal defects.
为了成功地使用 Amplatzer 房间隔封堵器进行房间隔缺损的经导管闭合，在选择器械之前应考虑缺损的形状。本研究的目的是评估经导管闭合卵圆形房间隔缺损的结果。
从 2009 年 11 月至 2011 年 11 月，对 69 例需要经导管闭合房间隔缺损的患者进行了心脏计算机断层扫描。我们将最短直径与最长直径之比≤0.75 的卵圆形房间隔缺损定义为计算机断层扫描测量值。术后一天和六个月后进行经胸超声心动图检查。
在卵圆组 24 例和圆形组 45 例患者中成功进行了经导管闭合房间隔缺损。两组均无严重并发症，卵圆组和圆形组在 6 个月后的完全闭合率分别为 92.3%和 93.1%（p>0.05）。卵圆组的器械尺寸与缺损最长直径的比值和器械尺寸与最长直径的比值明显小于圆形组（1.8 ± 2.8 比 3.7 ± 2.6 和 1.1 ± 0.1 比 1.2 ± 0.2）。
与圆形房间隔缺损相比，使用较小的 Amplatzer 房间隔封堵器器械闭合卵圆形房间隔缺损是安全的。
