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采用肺静脉滑出辅助植入技术经导管闭合大型房间隔缺损伴下缘缺失：一例报告

Catheter-based closure of a large atrial septal defect with inferior rim deficiency using pulmonary vein slide-out assisted implantation technique: a case report.

作者信息

Evola Salvatore, Triolo Oreste Fabio, Novo Giuseppina, Onorato Eustaquio Maria

机构信息

Department of Medicine and Cardiology, Catheterization Laboratory, Azienda Ospedaliera Universitaria Policlinico "P.Giaccone", Palermo, Italy.

Dipartimento Promise, Università di Palermo, UOC Cardiologia, Azienda Ospedaliera Universitaria Policlinico "P.Giaccone", Palermo, Italy.

出版信息

Eur Heart J Case Rep. 2021 Feb 8;5(2):ytab016. doi: 10.1093/ehjcr/ytab016. eCollection 2021 Feb.

DOI:10.1093/ehjcr/ytab016
PMID:33644664
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7898564/
Abstract

BACKGROUND

Transcatheter approach for large and complex atrial septal defects may represent a therapeutic challenge, particularly when the postero-inferior rim is deficient and floppy.

CASE SUMMARY

Here, we describe a successful catheter-based closure of a large (>30 mm) secundum atrial septal defect associated with postero-inferior rim deficiency in a 35-year-old female with congestive heart failure using pulmonary vein slide-out assisted implantation technique.

DISCUSSION

Inferior-posterior rim deficiency is a well-known risk factor for device instability or embolization. Transcatheter closure may represent a safe and effective alternative to the traditional surgical approach provided that modified implantation techniques are employed.

摘要

背景

经导管治疗大型复杂房间隔缺损可能是一项治疗挑战，尤其是当后下缘缺损且松软时。

病例摘要

在此，我们描述了一名35岁患有充血性心力衰竭的女性，使用肺静脉滑出辅助植入技术，成功通过导管闭合了一个大于30毫米的继发孔型房间隔缺损，该缺损伴有后下缘缺损。

讨论

后下缘缺损是导致装置不稳定或栓塞的一个众所周知的危险因素。如果采用改良的植入技术，经导管闭合可能是传统手术方法的一种安全有效的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/664c9f3b901d/ytab016f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/c8a8667e901e/ytab016f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/b70414214d98/ytab016f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/5eff3d10a46c/ytab016f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/77f96cc709a3/ytab016f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/7d61b493961f/ytab016f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/664c9f3b901d/ytab016f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/c8a8667e901e/ytab016f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/b70414214d98/ytab016f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/5eff3d10a46c/ytab016f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/77f96cc709a3/ytab016f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/7d61b493961f/ytab016f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e354/7898564/664c9f3b901d/ytab016f6.jpg

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本文引用的文献

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Interventional Therapy Versus Medical Therapy for Secundum Atrial Septal Defect: A Systematic Review (Part 2) for the 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.介入治疗与药物治疗继发房间隔缺损的比较：2018 年 AHA/ACC 成人先天性心脏病管理指南的系统评价（第 2 部分）：美国心脏病学会/美国心脏协会实践指南委员会的报告。
J Am Coll Cardiol. 2019 Apr 2;73(12):1579-1595. doi: 10.1016/j.jacc.2018.08.1032. Epub 2018 Aug 16.
2
Utility of balloon assisted technique in trans catheter closure of very large (≥35 mm) atrial septal defects.球囊辅助技术在经导管闭合非常大（≥35mm）房间隔缺损中的应用。
Cardiovasc Diagn Ther. 2014 Feb;4(1):21-7. doi: 10.3978/j.issn.2223-3652.2014.02.05.
3
Transcatheter closure of secundum atrial septal defects: results in patients with large and extreme defects.经导管闭合继发房间隔缺损：大及极重度缺损患者的结果。
Heart Lung Circ. 2014 Feb;23(2):127-31. doi: 10.1016/j.hlc.2013.07.020. Epub 2013 Sep 4.
4
Live/Real time three-dimensional transesophageal echocardiography in percutaneous closure of atrial septal defects.实时三维经食管超声心动图在经皮房间隔缺损封堵术中的应用
Echocardiography. 2013 Mar;30(3):345-53. doi: 10.1111/echo.12106. Epub 2013 Jan 22.
5
Effect of atrial septal defect shape evaluated using three-dimensional transesophageal echocardiography on size measurements for percutaneous closure.经三维经食管超声心动图评估的房间隔缺损形状对经皮封堵的大小测量的影响。
J Am Soc Echocardiogr. 2012 Oct;25(10):1031-40. doi: 10.1016/j.echo.2012.07.017. Epub 2012 Aug 9.
6
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7
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