Chen Qiang, Cao Hua, Zhang Gui-Can, Chen Liang-Wan, Xu Fan, Zhang Jia-Xin
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29#, Fuzhou, 350001, People's Republic of China.
J Cardiothorac Surg. 2017 Sep 2;12(1):74. doi: 10.1186/s13019-017-0639-8.
The purpose of this study was to outline the midterm follow-up results and complications in patients who underwent transthoracic device closure of an atrial septal defect (ASD) with the very large domestic occluder (44-48 mm).
The data of 35 patients who underwent transthoracic device closure of an ASD with the very large domestic occluder (44-48 mm) at our institution were collected prospectively between January 2010 and January 2015. All patients were invited for an outpatient visit and contrast TTE for 12-70 months after ASD closure.
Thirty-four patients were occluded successfully under this approach and 1 patient was transferred for surgical repair for dislodgement of the occluder. The most frequent complication was transient cardiac arrhythmia. A new third degree atrioventricular block occurred in 1 patient who recovered 1 week later. During the follow-up period, we found no recurrence, no thrombosis, no device embolization, no device failure, and no cases of death. The total occlusion rate was 94.1% in the 12 months of follow-up, and the intracardiac structure and cardiac function were significant improved contemporaneously.
Transthoracic device closure of an atrial septal defect with the very large domestic occluder (44-48 mm) is a safe and feasible technique. However, long-term follow-up is required to better assess the safety and feasibility of this method for the closure of very large ASDs in patients.
本研究旨在概述使用国产大型封堵器（44 - 48毫米）经胸封堵房间隔缺损（ASD）患者的中期随访结果及并发症。
前瞻性收集2010年1月至2015年1月在我院使用国产大型封堵器（44 - 48毫米）经胸封堵ASD的35例患者的数据。所有患者在ASD封堵术后12 - 70个月被邀请进行门诊随访及对比增强经胸超声心动图检查。
34例患者采用该方法封堵成功，1例患者因封堵器移位转至外科手术修复。最常见的并发症是短暂性心律失常。1例患者出现新的三度房室传导阻滞，1周后恢复。随访期间，未发现复发、血栓形成、封堵器栓塞、封堵器故障及死亡病例。随访12个月时总封堵率为94.1%，同期心内结构和心功能显著改善。
使用国产大型封堵器（44 - 48毫米）经胸封堵房间隔缺损是一种安全可行的技术。然而，需要长期随访以更好地评估该方法在封堵大型ASD患者中的安全性和可行性。
