Cong Juan, Cui Cunying, Huang Danqing, Wang Ying, Liu Sifan, Song Shubo, Fan Taibing
Department of Ultrasound, Fuwai Central China Cardiovascular Hospital, Fuwai Central China Hospital of Zhengzhou University, Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
Department of Children's Heart Center, Fuwai Central China Cardiovascular Hospital, Fuwai Central China Hospital of Zhengzhou University, Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
Front Cardiovasc Med. 2024 Jul 2;11:1420704. doi: 10.3389/fcvm.2024.1420704. eCollection 2024.
The aim of this study was to investigate the morphologic changes of a novel fully biodegradable implantable device after closing a perimembranous ventricular septal defect (Pm-VSD) and to evaluate the effect of the occluder on the myocardial function in patients during a 3-year follow-up period.
One-year, 2-year, and 3-year follow-ups were carried out after implantation with a total of 30 Pm-VSD patients who had successful closure by the fully biodegradable occluder. In total, 30 healthy children were enrolled as controls. At discharge and at every follow-up visit, the lengths of the left and right discs of the novel device were measured in the apical three- and four-chamber as well as short-axis views. At the end of the follow-up, using three-dimensional speckle-tracking conditions, the values of myocardial deformation, including global longitudinal strain, global circumferential strain, and global area strain, were acquired.
The fully bioabsorbable double-disc occluder gradually decreased over time and was eventually invisible under echocardiographic scanning during the follow-up (< 0.05). At the end of the third year, there were no significant differences in the myocardial deformation parameters between the cases implanted with the novel devices and the controls; no significant differences were found between the basal segments of the ventricle septa and that of the left ventricle (LV) free wall among the patients who completed the Pm-VSD closure using the fully biodegradable occluder (> 0.05).
The novel fully biodegradable occluder is a safe, effective, and perfect alternative for the treatment of VSD. Echocardiography plays a crucial role in the follow-up of this new type of occluder implantation.
本研究旨在调查一种新型完全可生物降解植入装置在闭合膜周部室间隔缺损(Pm-VSD)后的形态学变化,并评估封堵器在3年随访期内对患者心肌功能的影响。
对30例使用完全可生物降解封堵器成功闭合Pm-VSD的患者进行植入术后1年、2年和3年的随访。总共纳入30名健康儿童作为对照。在出院时和每次随访时,在心尖三腔和四腔以及短轴视图中测量新型装置左右盘片的长度。随访结束时,使用三维斑点追踪技术,获取心肌变形值,包括整体纵向应变、整体圆周应变和整体面积应变。
完全可生物吸收双盘封堵器随时间逐渐减小,在随访期间经超声心动图扫描最终不可见(<0.05)。在第三年末,植入新型装置的病例与对照组之间的心肌变形参数无显著差异;在使用完全可生物降解封堵器完成Pm-VSD闭合的患者中,室间隔基底段与左心室(LV)游离壁基底段之间未发现显著差异(>0.05)。
新型完全可生物降解封堵器是治疗VSD的一种安全、有效且理想的替代方法。超声心动图在这种新型封堵器植入的随访中起着关键作用。