【摘要】 目的 :观察经导管堵闭治疗继发孔型房间隔缺损 (ASD)的疗效。方法 :经胸超声心动图 (TTE)和心导管检查诊断为ASD ,从股静脉插入球囊导管至ASD ,测量ASD径后 ,从股静脉插入长鞘管经右心房 (RA)至左心房(LA) ,沿鞘管插入房间隔堵闭器 (ASO)至LA ,在透视和TTE引导下推出ASO堵闭ASD。结果 :32例病人用导管法治疗 ,2 8例堵闭成功 ,手术结束时TTE显示无残余分流。出院前重作TTE ,RA径由 (39.4± 5 .8)mm降至 (33.7± 4 .2 )mm(P <0 .0 0 1) ,右室径由 (4 5 .3± 6 .8)mm降至 (37.1± 4 .5 )mm (P <0 .0 0 1)。 2例因无合适的ASO改行开胸手术。 2例术中ASO脱落 ,外科手术取出ASO并修补ASD。未见其它并发症。结论 :经导管堵闭ASD具有创伤小 ,成功率高 ,安全性好的优点 ,适用于大多数ASD患者。更多还原

【Abstract】 Objective To evaluate the effect of transcatheter closure treatment for secundum atrial septal defect(ASD). Methods ASD was established by transthoracic echocardiogram (TTE) and transvenous cardiac catheterization. A balloon catheter was inserted at ASD and was inflated to measure the ASD stretched diameter. Then, a long sheath was inserted to the left atrium (LA) from the right atrium(RA).Thereafter a proper auto-expanded atrial septal occluder(ASO) was inserted to the tip of the sheath. Under the fluoroscopic and TTE guidance, the ASO was expanded. Once the position of ASO was optimal, it was released. Results From May 1999 to July 2002, 32 patients were treated with this method. Among them, 28 patients (87.5%) obtained satisfactory results. At the end of the operation, TTE could not find out any residual shunt. Before discharging the patients, TTE showed the diameter of the right atrium and the right ventricle were decreased from (39.4±5.8) mm to (33.7±4.2) mm and from (45.3±6.8) mm to (37.1±4.5) mm respectively (P<0.001 for both). The operation failed in 4 patients (12.5%). Two patients did not get proper ASO for them in the early period of our work. ASO slipped off from the defects in another 2 patients during the operation. There were no other complications. Conclusion Tanscatheter closure is suitable for most patients with ASD. It is safe and less invasive with few complications.更多还原