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经导管同期治疗膜周部室间隔缺损合并动脉导管未闭

Simultaneous transcatheter therapy for perimembranous ventricular septal defect combined with patent ductus arteriosus.

作者信息

Wang Qiguang, Zhu Xianyang, Duanzhen Zhang, Zhang Po, Chen Huoyuan, Han Xiumin, Sheng Xiaotang, Meng Lili

机构信息

Department of Congenital Heart Disease, General Hospital of Shenyang Military Command, Shenyang, Liaoning, P. R. China.

出版信息

J Card Surg. 2017 Jun;32(6):370-375. doi: 10.1111/jocs.13138. Epub 2017 May 11.

Abstract

OBJECTIVE

This study aims to assess the clinical efficiency and safety of simultaneous transcatheter interventional treatment for perimembranous ventricular septal defect (pmVSD) combined with patent ductus arteriosus (PDA).

METHODS

Twenty-five patients with pmVSD and PDA treated with simultaneous transcatheter interventions from April 2004 to December 2015 were included in this study. The mean age was 9.80 ± 8.14 years and the mean weight was 29.76 ± 14.82 Kg. Transthoracic echocardiography (TTE) and angiography were performed immediately after the procedure. Patients were re-examined by electrocardiogram, X-ray, and TTE at 2 days, 1 month, 3 months, and 6 months postoperatively.

RESULTS

The interventional procedure was successfully performed in all 25 patients. No intraoperative complication was noted. TTE examination of the VSD and PDA immediately after the procedure showed no residual shunt and the occluder was well positioned. Among these patients, four patients showed electrocardiogram changes after the procedure that resolved after drug therapy. The cardiothoracic ratio, left atrial diameter, left ventricular end-systolic diameter, and left ventricular end-diastolic diameter recovered to normal in most patients at 6 months postoperatively.

CONCLUSIONS

Simultaneously transcatheter interventional therapy is a safe and effective method for pmVSD combined with PDA.

摘要

目的

本研究旨在评估经导管同期介入治疗膜周部室间隔缺损(pmVSD)合并动脉导管未闭(PDA)的临床疗效及安全性。

方法

纳入2004年4月至2015年12月期间接受经导管同期介入治疗的25例pmVSD合并PDA患者。平均年龄为9.80±8.14岁,平均体重为29.76±14.82千克。术后立即进行经胸超声心动图(TTE)和血管造影检查。术后2天、1个月、3个月和6个月对患者进行心电图、X线和TTE复查。

结果

25例患者均成功完成介入手术。术中未发现并发症。术后立即进行的VSD和PDA的TTE检查显示无残余分流,封堵器位置良好。其中4例患者术后出现心电图改变,经药物治疗后恢复。大多数患者术后6个月心胸比率、左心房内径、左心室收缩末期内径和左心室舒张末期内径恢复正常。

结论

经导管同期介入治疗是pmVSD合并PDA的一种安全有效的方法。

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