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经皮导管封堵多发性房间隔缺损的个体化经验:一项单中心研究

Individualized Experience With Percutaneous Transcatheter Closure of Multiple Atrial Septal Defects: A Single-Center Study.

作者信息

Wang Zhenquan, Zhan Yi, Jin Jiahui, Wu Tingting, Zhang Songyue, Qiu Huixian, Wang Qiaoyu, Wu Rongzhou

机构信息

Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.

出版信息

Front Cardiovasc Med. 2021 Feb 15;8:628322. doi: 10.3389/fcvm.2021.628322. eCollection 2021.

Abstract

Multiple atrial septal defects (ASDs) are one type of secundum ASD, most of which have an atrial septal aneurysm or long interdefect distance. In our retrospective single-center study, we reviewed different closure strategies for multiple ASDs. We analyzed 50 patients who underwent percutaneous transcatheter closure from May 2011 to July 2019. Information on the patients' characteristics, operation procedure, occluder selection, and complications was collected. According to the feature of the defects and device choice, multiple ASDs were divided into five groups. A successful operation was achieved in every patient. A total of 50 patients were implanted with 58 devices, with 26 patients implanted with a single standard ASD occluder (ASDO); six patients were implanted with double standard ASDOs, and only one patient was implanted with three standard ASDOs. There were 17 patients whose closure was made using the small-waist-big-edge ASDO. Seventy-six percent of the patients (38/50) had an immediate residual shunt. During the mean follow-up of 25.76 ± 22.53 months, the complete closure rate was 92%. Except for two patients with a transient atrioventricular block, individualized experience with percutaneous transcatheter closure for multiple ASDs was effective in a single-center study. After a mid- to long-term follow-up, the multiple ASDOs and small-waist-big-edge ASDO had no serious adverse events or complications.

摘要

多发性房间隔缺损(ASD)是继发孔型ASD的一种类型,其中大多数伴有房间隔瘤或缺损间距离较长。在我们的回顾性单中心研究中,我们回顾了多发性ASD的不同封堵策略。我们分析了2011年5月至2019年7月期间接受经皮导管封堵术的50例患者。收集了患者的特征、手术过程、封堵器选择和并发症等信息。根据缺损特点和器械选择,将多发性ASD分为五组。所有患者手术均成功。共50例患者植入了58个封堵器,其中26例患者植入单个标准房间隔缺损封堵器(ASDO);6例患者植入双标准ASDO,仅1例患者植入三个标准ASDO。17例患者使用小腰大边ASDO进行封堵。76%的患者(38/50)术后即刻存在残余分流。在平均25.76±22.53个月的随访期间,完全封堵率为92%。除2例出现短暂性房室传导阻滞外,在单中心研究中,经皮导管封堵多发性ASD的个体化经验是有效的。经过中长期随访,多发性ASDO和小腰大边ASDO均未出现严重不良事件或并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0215/7917059/aaac98a63f03/fcvm-08-628322-g0001.jpg

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