【摘要】 目的 :评价应用Amplatzer封堵器经导管治疗二孔型房间隔缺损 (ASD)的即刻疗效和超声心动图随访的近期效果。方法 :2 1例二孔型房间隔缺损患者 (男 12女 9,年龄 12～ 4 6岁 ) ,在透视及经食道超声心动图 (TEE)监视下采用Amplatzer封堵器封堵ASD ,TEE观察术后即刻封堵情况、经胸超声心动图 (TTE)比较术后 3d、1个月、6个月及 12个月心脏分流及心功能情况、术后并发症。结果 :除 1例因房间隔缺损太大 (大于 4 0mm)外 ,手术即刻成功率 10 0 % ,术中无任何严重并发症 ,10例病人球囊测得房间隔缺损直径 2 0～ 36mm ,选用封堵器直径 2 4～ 38mm ,术后即刻TEE检查示 3例存在微量残余分流 ,术后 3dTTE检查示 2例存在残余分流 ,6例病人完成 12个月随访 ,无 1例存在残余分流 ,无 1例封堵器脱落 ,X线检查示所有患者肺血减少 ,TTE检查示右心房、右心室缩小 ,心功能改善。结论 :经导管应用Amplatzer封堵器治疗二孔型ASD是一种安全、有效的非手术治疗方法 ,近、中期疗效可靠 ,值得临床推广应用更多还原

【Abstract】 Objective: To evaluate the efficiency and echocardiographic follow up results of transcatheter closure secundum atrial septal defect (ASD) with Amplatzer occluder.Methods:Twenty one patients(12 males and 9 females,ages 12～46)with secundum ASD were recruited.Each ASD was occluded with Amplatzer occluder through the percutaneous procedure,which was guided by fluoroscopy and transesophageal echocardiography(TEE).TEE was performed immediately and transthoracic echocardiography(TTE) was performed at 3 days,1 month,3 months, 6 months, and 12 months after the procedure to evaluate the efficiency.Results:The successful rate of technique was 100%,except the size of ASD was too large to be occluded in one case.The diameter of ASD ranged from 20 mm to 36mm in these patients,and Amplatzer occluder 24 mm to 38 mm.The trivial residual shunt was found immediately after the procedures in 3 cases and in 3 days in 2 cases.Six patients completed 12 month follow up.No residual shunt was found and no closure lost in all.Conclusion:Transcatheter closure of secundum ASD using Amplazter occluder device would be an efficient nonsurgical method. It has a high successful rate of technique and satisfied immediate and short term results.更多还原