胸部刺伤后创伤性室间隔缺损的一期经皮封堵：一例报告
Primary percutaneous closure of a traumatic ventricular septal defect after stab wound to the chest: a case report.
作者信息
Solórzano Vázquez Marco Alejandro, Medina Torres Oscar Samuel, Tiscareño Villanueva Ashby Daniel, Villar Valencia Cristian Adrián
机构信息
Interventional Cardiology Department, Mexican Social Security Institute Bajío Center UMAE T1, Blvd Adolfo López Mateos SN Colonia, los Paraisos, 37328 León Guanajuato, México.
出版信息
Eur Heart J Case Rep. 2023 Jul 12;7(7):ytad314. doi: 10.1093/ehjcr/ytad314. eCollection 2023 Jul.
BACKGROUND
Traumatic ventricular septal defects (VSDs) are life-threatening complications of blunt or stab chest trauma. The standard of care is surgical closure or secondary percutaneous closure due to high surgical risk because of recent sternotomy.
CASE SUMMARY
We present a 22-year-old male with an ice pick-related VSD. It was successfully closed by primary percutaneous approach. After 6 months, the echo Doppler shows no residual shunt, normal pulmonary artery pressure, and normal biventricular function.
DISCUSSION
To our knowledge, this is one of the first primary percutaneous closures for knife-related VSD. Early diagnosis and treatment can prevent heart failure and long-term complications. Less necrotic tissue surrounding the VSD compared with post-infarction (PI) VSD allows for early and secure treatment. Percutaneous closure is a feasible and effective choice even in patients who had no prior sternotomy or who reject surgery as a primary treatment strategy.
背景
创伤性室间隔缺损（VSD）是钝性或穿透性胸部创伤危及生命的并发症。由于近期胸骨切开术导致手术风险高，治疗标准是手术闭合或二期经皮闭合。
病例摘要
我们报告一名22岁男性因冰锥导致的室间隔缺损。通过一期经皮方法成功闭合。6个月后，超声多普勒显示无残余分流、肺动脉压正常和双心室功能正常。
讨论
据我们所知，这是首例刀伤相关室间隔缺损的一期经皮闭合。早期诊断和治疗可预防心力衰竭和长期并发症。与心肌梗死后（PI）室间隔缺损相比，室间隔缺损周围坏死组织较少，可进行早期安全治疗。即使对于未行胸骨切开术或拒绝手术作为主要治疗策略的患者，经皮闭合也是一种可行且有效的选择。
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