改良动静脉环技术用于成功顺行封堵合并主动脉瓣脱垂的膜周部室间隔缺损——单中心经验
Modified Arteriovenous Loop Technique for Successful Antegrade Device Closure of Perimembranous Ventricular Septal Defects with Aortic Valve Prolapse-A Single-Center Experience.
作者信息
Sivaprakasam Muthukumaran Chinnasamy, Ganesan Rajaguru, Ramkishore S, Saranya A, Girija Haritha, Arun V, Mahitha V, Solomon Neville, Swaminathan V, Giriwar D
机构信息
Department of Pediatric Cardiology, Apollo Children's Hospital, Thousand Lights, Chennai, Tamilnadu, 600006, India.
Department of Cardiothoracic Surgery, Apollo Children's Hospital, Chennai, Tamilnadu, India.
出版信息
Pediatr Cardiol. 2025 Apr 28. doi: 10.1007/s00246-025-03871-z.
In ventricular septal defects (VSDs) close to aortic valve, mostly surgical closure is preferred. Currently, transcatheter method of device closure is done in selective cases with satisfactory results. Perimembranous with outflow extension VSDs having mild aortic valve prolapse with trivial to mild aortic regurgitation (AR) were selected. VSD devices were deployed through antegrade route with our modification of standard arteriovenous (A-V) loop technique to prevent aortic valve compression and progression of AR. Among 55 cases of perimembranous VSDs having outlet extension with aortic valve prolapse, 44 (80%) cases had successful closure with our modified technique and 11 (20%) underwent surgical closure as device closure was not amenable. At 1 year follow-up, the VSD closure rate was 91% with trivial and mild AR persisting in 24.4% and 5% of cases, respectively. Satisfactory closure of VSDs close to aortic valve is possible with our modified A-V loop technique.
对于靠近主动脉瓣的室间隔缺损（VSD），大多首选外科手术闭合。目前，在选择性病例中采用经导管装置闭合方法，效果令人满意。选取了伴有流出道延伸的膜周部室间隔缺损且伴有轻度主动脉瓣脱垂及轻度至轻度主动脉反流（AR）的病例。通过顺行途径采用我们改良的标准动静脉（A-V）圈套技术部署室间隔缺损封堵装置，以防止主动脉瓣受压和主动脉反流进展。在55例伴有流出道延伸且主动脉瓣脱垂的膜周部室间隔缺损病例中，44例（80%）采用我们改良技术成功闭合，11例（20%）因无法进行装置闭合而接受外科手术闭合。在1年随访时，室间隔缺损闭合率为91%，分别有24.4%和5%的病例存在轻度和轻度主动脉反流。采用我们改良的A-V圈套技术可以实现靠近主动脉瓣的室间隔缺损的满意闭合。
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