【摘要】 目的:探讨偏心型封堵器适用的室间隔缺损类型及超声心动图在外科微创封堵术中对偏心型封堵器选型的作用、成功封堵的关键及操作中避免损伤的经验。方法:对179例采用偏心型封堵器成功施行外科微创封堵术的室间隔缺损患儿进行回顾性研究,分析适用偏心型封堵器的缺损类型、大小及形态,及通过随访评估偏心型封堵器封堵室间隔缺损的疗效。结果:成功使用偏心型封堵器的179例室间隔缺损患儿中膜周型占86.59%,双动脉下型占13.41%。封堵器型号选择一般比缺损测量最大径大2~3 mm。随访示封堵器位置正确,固定满意,无轻量以上残余分流及瓣膜反流,无严重传导阻滞发生。结论:偏心型封堵器的应用较好的扩大了外科微创封堵术的适用范围,超声心动图引导封堵器正确放置能较好保证手术的安全性和成功率。更多还原

【Abstract】 Objective: To discuss the suitable types of ventricular septal defects for asymmetric occluders,and elucidate the critical role of echocardiography in choosing occluders,guiding successful occlusion and avoiding injury during operation.Methods: We retrospectively studied 179 patients with ventricular septal defects who received minimal-invasive surgical device closure with asymmetric occluder.We analyzed the types,size and morphology of ventricular septal defects suitable for asymmetric occluders.The therapeutic efficiency was evaluated by follow-ups.Results: Out of the 179 successful cases treated with asymmetric occluders,86.59% had perimembranous ventricular septal defects,and double-committed sub-arterial ventricular septal defects accounted for 13.41%.In general,the size of occluders to be selected was the maximum diameter of the defects plus 2–3 mm.Follow-ups showed that occluders were placed and fixed properly.No severe residual shunt,valve regurgitation or heart block were discovered.Conclusion: Application of asymmetric occluders expands the range of indications for occlusion via small chest incision.Accurate echocardiography helps to improve the safety and successful rate of the surgery.更多还原