Rao Seema S, Scaff Tyler L, Gurley John, Saha Sibu
University of Kentucky College of Medicine, Lexington, Kentucky.
Department of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky Medical Center, Lexington, Kentucky.
Int J Angiol. 2018 Mar;27(1):39-42. doi: 10.1055/s-0038-1626718. Epub 2018 Jan 30.
Device therapy is a viable alternative to open heart surgery in the management of intracardiac defects. The Amplatzer septal occluder (ASO) is one such device that has been adapted to close a wide variety of cardiac defects with few complications and a high success rate. This is a retrospective review of all the patients who received the ASO between 2012 and 2016 at the University of Kentucky. In total, 169 patients underwent percutaneous closure of a septal defect with Amplatzer during the timeframe studied, and of those, 91% received the device for an atrial septal defect or patent foramen ovale. Patients presented with stroke, transient ischemic attack, migraine, dyspnea or other symptoms and were diagnosed by transesophageal echocardiography and cardiac catheterization. All Amplatzer devices achieved successful closure without requiring a second procedure. Four patients sustained complications of the procedure, with two experiencing tamponade, one with hematoma, and one with cellulitis. The Amplatzer device was not directly implicated in the three fatalities that occurred within 30 days of the septal occlusion procedure. The ASO has performed very well at our institution and we expect it to serve additional functions as the field of transcatheter cardiology develops.
在治疗心脏内缺损方面,器械治疗是心脏直视手术的一种可行替代方案。Amplatzer房间隔封堵器(ASO)就是这样一种器械,它已被用于闭合多种心脏缺损,并发症少且成功率高。这是一项对2012年至2016年期间在肯塔基大学接受ASO治疗的所有患者的回顾性研究。在研究期间,共有169例患者经皮使用Amplatzer封堵器闭合房间隔缺损,其中91%的患者使用该器械治疗房间隔缺损或卵圆孔未闭。患者表现为中风、短暂性脑缺血发作、偏头痛、呼吸困难或其他症状,并通过经食管超声心动图和心导管检查确诊。所有Amplatzer器械均成功闭合,无需二次手术。4例患者出现手术并发症,2例发生心包填塞,1例出现血肿,1例发生蜂窝织炎。在房间隔封堵手术后30天内发生的3例死亡病例中,Amplatzer器械并非直接原因。ASO在我们机构表现良好,随着经导管心脏病学领域的发展,我们预计它将发挥更多作用。