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婴儿房间隔缺损经胸封堵装置闭合术的短期和中期随访

Short-Term and Midterm Follow-Up of Transthoracic Device Closure of Atrial Septal Defect in Infants.

作者信息

Chen Qiang, Cao Hua, Zhang Gui-Can, Chen Liang-Wan, Xu Fan, Zhang Jia-Xin

机构信息

Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.

Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.

出版信息

Ann Thorac Surg. 2017 Oct;104(4):1403-1409. doi: 10.1016/j.athoracsur.2017.02.085. Epub 2017 Jun 1.

Abstract

BACKGROUND

The purpose of this study was to outline the safety and feasibility of transthoracic device closure of an atrial septal defect (ASD) with a domestic occluder in infants.

METHODS

Sixty-eight infants underwent transthoracic device closure of an ASD at Union Hospital, Fujian Medical University, Fuzhou, China from January 2010 to January 2015. All relevant clinical data were recorded and analyzed. All patients were invited to undergo contrast transthoracic echocardiography for 12 to 60 months after ASD closure, and telephone interviews were conducted with the infants' parents to evaluate the patients' clinical status further.

RESULTS

All patients had successful ASD occlusion using this approach. The most frequent complication was transient cardiac arrhythmia, which was easily treated or automatically recovered during the perioperative period. During the follow-up period, no recurrence, thrombosis, device embolization, valve damage, device failure, or death was reported. The total occlusion rate was 100% in the 12 months of follow-up, and all patients showed significant improvement in their clinical status. From transthoracic echocardiographic data, intracardiac structure and cardiac function were significantly improved at follow-up.

CONCLUSIONS

Transthoracic device closure of an ASD with a domestic occluder in infants is a safe and feasible technique. The short- and medium-term follow-up results were satisfactory, but long-term follow-up is required to assess the safety and feasibility of this method in infants more accurately.

摘要

背景

本研究旨在概述采用国产封堵器经胸封堵婴儿房间隔缺损(ASD)的安全性和可行性。

方法

2010年1月至2015年1月,68例婴儿在福建医科大学附属协和医院接受了经胸封堵ASD治疗。记录并分析所有相关临床资料。所有患者在ASD封堵术后12至60个月接受经胸超声心动图造影检查,并对婴儿家长进行电话随访以进一步评估患者的临床状况。

结果

所有患者采用该方法均成功封堵ASD。最常见的并发症是短暂性心律失常,在围手术期易于治疗或自动恢复。随访期间,未报告复发、血栓形成、封堵器栓塞、瓣膜损伤、封堵器故障或死亡。随访12个月时总封堵率为100%,所有患者临床状况均有显著改善。根据经胸超声心动图数据,随访时心脏内结构和心功能有显著改善。

结论

采用国产封堵器经胸封堵婴儿ASD是一种安全可行的技术。短期和中期随访结果令人满意,但需要长期随访以更准确地评估该方法对婴儿的安全性和可行性。

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