Odemis Ender, Saygi Murat, Guzeltas Alper, Tanidir I Cansaran, Ergul Yakup, Ozyilmaz Isa, Bakir Ihsan
Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Bezirganbahce Street, Halkali, Istanbul, 34303, Turkey,
Pediatr Cardiol. 2014 Jun;35(5):817-23. doi: 10.1007/s00246-013-0860-8. Epub 2014 Jan 12.
Our objective was to investigate the short- and mid-term results of transcatheter ventricular septal defect (VSD) closure with the Nit-Occlud(®) Lê VSD coil. Retrospective data collection study. Data were collected from 20 patients who underwent transcatheter VSD closure with the Nit-Occlud(®) Lê VSD coil device between October 2011 and June 2013. The mean age of the study subjects was 7.3 ± 4.0 years, and the mean weight was 25.7 ± 11.8 kg. The distance between the defect and the aortic valve, measured using angiography, was an average of 5.1 ± 2.0 mm, and the left ventricular opening averaged 8.2 ± 2.1 mm. The mean value of the Q p/Q s ratio was 1.7 ± 0.4. Intravascular hemolysis developed in the first few hours after the procedure in three patients. In one of these cases, despite medical treatment and the implantation of a detachable coil placed into the Nit-Occlud(®) device transcatheterly, hemolysis persisted. This device was removed and the VSD was closed surgically. In the other two cases, although the residual shunt persisted on echocardiography, the hemolysis regressed spontaneously. There were no rhythm problems or other complications during the follow-up period of 12.3 ± 6.6 months. In the selected cases, for the transcatheter treatment of VSD, the Nit-Occlud(®) Lê VSD coil device can be used. When compared with other VSD closure devices, there was no development of a permanent atrioventricular block, which is an important advantage. However, patients with a residual shunt should be monitored closely for the development of hemolysis during the first few hours.
我们的目的是研究使用Nit-Occlud(®) Lê室间隔缺损(VSD)封堵线圈进行经导管室间隔缺损封堵术的短期和中期结果。回顾性数据收集研究。收集了2011年10月至2013年6月期间使用Nit-Occlud(®) Lê VSD封堵线圈装置进行经导管VSD封堵术的20例患者的数据。研究对象的平均年龄为7.3±4.0岁,平均体重为25.7±11.8 kg。使用血管造影测量的缺损与主动脉瓣之间的距离平均为5.1±2.0 mm,左心室开口平均为8.2±2.1 mm。Q p/Q s比值的平均值为1.7±0.4。3例患者在术后最初几小时内发生了血管内溶血。其中1例患者,尽管进行了药物治疗并经导管在Nit-Occlud(®) 装置中植入了可分离线圈,但溶血仍持续存在。该装置被移除,VSD通过手术关闭。在另外2例患者中,尽管超声心动图显示仍有残余分流,但溶血自发消退。在12.3±6.6个月的随访期内未出现节律问题或其他并发症。在选定的病例中,对于VSD的经导管治疗,可使用Nit-Occlud(®) Lê VSD封堵线圈装置。与其他VSD封堵装置相比,未发生永久性房室传导阻滞,这是一个重要优势。然而,对于有残余分流的患者,在最初几小时内应密切监测溶血的发生情况。