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小儿经导管装置闭合膜周部室间隔缺损:长期结果

Transcatheter Device Closure of Perimembranous Ventricular Septal Defect in Pediatric Patients: Long-Term Outcomes.

作者信息

Shah Jayal Hasmukhbhai, Saraiya Sanket Pravinchandra, Nikam Tushar Sudhakarrao, Jha Mukesh Jitendra

机构信息

Department of Cardiology, U N Mehta Institute of Cardiology and Research Center, Civil Hospital Campus, Ahmedabad, Gujarat, India.

出版信息

Heart Views. 2020 Jan-Mar;21(1):17-21. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_13_19. Epub 2020 Jan 23.

Abstract

AIMS

The aim of this study is to evaluate the safety and efficacy of transcatheter device closure of perimembranous ventricular septal defects in pediatric patients at long-term follow-up.

MATERIALS AND METHODS

We prospectively studied 376 patients with perimembranous VSDs between September 2008 and December 2015 who underwent percutaneous closure at our center. Transthoracic echocardiography (TTE) and electrocardiogram were done before and after the procedure in all the patients. All patients were subjected to follow-up evaluation at 1, 3, 6, 12 months, and annually thereafter with TTE and electrocardiogram.

RESULTS

A total of 376 patients (210 males and 166 females) underwent transcatheter closure of perimembranous VSD. Mean age of patients was 8.67 ± 3.02 (range 3-18 years) and mean weight was 21.15 ± 8.31 (range 8-65 kg). The procedure was carried out successfully in 98.93% of patients with no reported mortality. Rhythm disturbances occurred in 8.5% of patients after the procedure which included three cases of complete atrioventricular block.

CONCLUSION

This study shows that in experienced hands transcatheter closure of perimembrnous VSD is safe and effective at long-term follow-up. With minimal morbidity and no mortality, the transcatheter is an effective alternative to surgical closure in selected patients.

摘要

目的

本研究旨在评估小儿患者经导管装置闭合膜周部室间隔缺损的长期安全性和有效性。

材料与方法

我们前瞻性研究了2008年9月至2015年12月期间在本中心接受经皮闭合术的376例膜周部室间隔缺损患者。所有患者在手术前后均进行了经胸超声心动图(TTE)和心电图检查。所有患者在术后1、3、6、12个月以及此后每年接受TTE和心电图的随访评估。

结果

共有376例患者(210例男性和166例女性)接受了膜周部室间隔缺损的经导管闭合术。患者的平均年龄为8.67±3.02岁(范围3 - 18岁),平均体重为21.15±8.31 kg(范围8 - 65 kg)。98.93%的患者手术成功,无死亡报告。术后8.5%的患者出现心律失常,其中包括3例完全性房室传导阻滞。

结论

本研究表明,在经验丰富的医生操作下,膜周部室间隔缺损的经导管闭合术在长期随访中是安全有效的。发病率极低且无死亡,经导管闭合术是部分患者外科手术闭合的有效替代方法。

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