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经导管封堵房间隔缺损:发展中国家与发达国家的可比经验及结果

Transcatheter Closure of Atrial Septal Defects: Comparable Experience and Outcomes Between Developing and Developed Countries.

作者信息

Almanla Ahmad, Charafeddine Fatme, Abutaqa Mohamad, Mustafa Hala, Tabbakh Anas, Hussein Haytham Bou, Sawaya Fadi, El-Rassi Issam, Arabi Mariam, Bulbul Ziad, Bitar Fadi

机构信息

Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon.

Children's Heart Center, AUBMC, Beirut, Lebanon.

出版信息

Pediatr Cardiol. 2019 Mar;40(3):610-615. doi: 10.1007/s00246-018-2034-1. Epub 2019 Jan 3.

Abstract

Atrial septal defect (ASD) is one of the most common congenital heart defects. Transcatheter device closure of ASDs is safe and effective with most of the reported data being described from developed countries. To evaluate the short and mid-term results and experience of device closure of ASDs at a tertiary center in a developing country and compare it to that from developed countries. Retrospective study based on data collection from all patients who have undergone transcatheter percutaneous device closure for ASD from January 2005 until December 2017 at the Children's Heart Center at the American University of Beirut, Medical Center, Lebanon. During the study period, a total of 254 cardiac catheterizations were performed for device closure of ASDs. The mean age of the patients was 18 ± 17.9 years with 37% being less than 6 years of age. Females were 54%. Defect size ranged from 7 to 37 mm and device size ranged from 8 to 40 mm. The procedure was executed with a success rate of 96%. Five patients had device embolization (2%); in one patient the device was snared and for the remainder the devices were removed surgically. None of the study patients had thrombus formation, neurological complications, bacterial endocarditis, or cardiac erosions. There was no mortality. Device closure of ASDs at our tertiary center in a developing country has an effective and safe profile with excellent results and low complications rates, which compare favorably to those reported from centers in developed countries.

摘要

房间隔缺损(ASD)是最常见的先天性心脏病之一。经导管封堵ASD安全有效,大多数报告数据来自发达国家。为评估在一个发展中国家的三级中心进行ASD封堵术的短期和中期结果及经验,并与发达国家的情况进行比较。基于2005年1月至2017年12月在黎巴嫩贝鲁特美国大学医学中心儿童心脏中心接受经导管经皮ASD封堵术的所有患者的数据收集进行回顾性研究。在研究期间,共进行了254次心脏导管插入术以封堵ASD。患者的平均年龄为18±17.9岁,其中37%年龄小于6岁。女性占54%。缺损大小为7至37毫米,封堵器大小为8至40毫米。手术成功率为96%。5例患者出现封堵器栓塞(2%);1例患者的封堵器被圈套住,其余患者的封堵器通过手术取出。研究患者均未出现血栓形成、神经系统并发症、细菌性心内膜炎或心脏侵蚀。无死亡病例。在我们这个发展中国家的三级中心,ASD封堵术效果安全有效,结果优异,并发症发生率低,与发达国家中心报告的情况相比具有优势。

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