【摘要】 目的 总结经食管超声心动图(TEE)引导下，微创经胸室间隔缺损(VSD)封堵治疗的临床经验。方法 11例VSD患者接受微创经胸封堵治疗，年龄3～6岁，体重12～65 kg, VSD直径3～8 mm。手术在TEE引导，胸骨下段小切口微创下进行，于右心室表面选择适当的穿刺点，建立输送轨道并完成VSD封堵。术后密切随访1～6个月。结果 11例中9例一次性安放成功，2例首次安放有残余分流，术中更换大号伞；心内操作时间10～36 min,平均(21±12)min。全部患者均于术后4～5天出院，随访1～6个月，效果良好。11例患者均无心律失常、残余分流等并发症发生。结论 TEE引导下微创经胸VSD封堵是一种安全有效的治疗方法，但远期结果有待进一步观察。更多还原

【Abstract】 Abstrat: Objectve To summarize the clinical experience of transcatheter closure of ventricular septal defects(VSD) through minimally invasive port-access surgery guided by transesophageal echocardiography(TEE). Methods A total of 11 patients aged from 3 to 6,weighting 12 kg to 65 kg were subjected to transcatheter closure of VSD with a diameter ranging from 3 mm to 8 mm. The surgery was performed under the guidance of TEE,where a small transthoracic incision was made. A proper site was chosen at the surface of the right ventricle for punctuation,in order to establish delivery pathway. Patients were closely followed up for 1 to 6 months. Results Among the patients were nice ones who successfully completed the surgery at one time. Residual shunts were seen in two cases which required the replacement of larger occluders. The time of intracardiac procedures was 10-36 min [(21 ± 12) min]. All patients were discharged 4to 5 days after operation. During fellow-up period,neither arrhythmia nor residual shunt occurred. Conclusion Transthoracic minimally invasive closure is a safe and efficient method for the treatment of VSD. Meanwhile,long-term fellow-up visits are indispensable.更多还原