Ergene Oktay, Kahya Eren Nihan, Nazlı Cem, Duygu Hamza, Kocabaş Uğur
Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Department of Cardiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.
Turk Kardiyol Dern Ars. 2015 Dec;43(8):699-704. doi: 10.5543/tkda.2015.50945.
Percutaneous closure of perimembranous ventricular septal defects (pmVSD) has become an accepted alternative to surgical closure in selected cases. However, closure of pmVSDs associated with septal aneurysm is more challenging. We report our experience of device closure of pmVSDs associated with septal aneurysm.
Between 2008 and 2012, percutaneous closure of pmVSD associated with septal aneurysm was attempted in 11 adult patients in our institution. The patients were followed up at 1, 3, 6, and 12 months after the procedure.
Mean age of the patients (64% male, 36% female) was 36.2±1.3 years. Diameter of the left and right ventricular openings of the aneurysm measured by ventriculography was 13.5±5.6 mm and 5.9±2.2 mm, respectively. The defect was occluded with Amplatzer pmVSD Occluder in 4 patients, Amplatzer Muscular Ventricular Septal Defect Occluder in 4 patients, Amplatzer Duct Occluder I in 1 patient, and Amplatzer Duct Occluder II in 2 patients (AGA Medical Corp., Plymouth, MN, USA). The procedure was succesfull in all patients. Mean follow-up time was 22±1.9 months. There was no device- or procedure-related complications at the acute setting or mid-term follow-up.
Percutaneous closure of pmVSDs associated with aneurysm is more challenging than that of simple defects. The selection of the device type and size should be made according to the configuration and size of the aneurysm and defect.
在特定病例中，经皮闭合膜周部室间隔缺损（pmVSD）已成为手术闭合的一种可接受的替代方法。然而，闭合与室间隔瘤相关的pmVSD更具挑战性。我们报告我们使用器械闭合与室间隔瘤相关的pmVSD的经验。
2008年至2012年期间，我们机构对11例成年患者尝试经皮闭合与室间隔瘤相关的pmVSD。术后1、3、6和12个月对患者进行随访。
患者平均年龄为36.2±1.3岁（男性占64%，女性占36%）。通过心室造影测量的瘤体左、右心室开口直径分别为13.5±5.6毫米和5.9±2.2毫米。4例患者使用Amplatzer pmVSD封堵器封堵缺损，4例患者使用Amplatzer肌部室间隔缺损封堵器，1例患者使用Amplatzer动脉导管未闭封堵器I，2例患者使用Amplatzer动脉导管未闭封堵器II（美国明尼苏达州普利茅斯市AGA医疗公司）。所有患者手术均成功。平均随访时间为22±1.9个月。在急性期或中期随访中未出现与器械或手术相关的并发症。
经皮闭合与室间隔瘤相关的pmVSD比单纯缺损更具挑战性。应根据瘤体和缺损的形态及大小选择器械类型和尺寸。
