先心病室间隔缺损封堵治疗前后胸部x线表现

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1、中国胸心血管外科临壅塑查!!!!生!旦箜!!查塑型ChinJClinThoracC—ardiovascSurg,Septem—ber2007,V01．14,SuPpl戮攀褥蓐簿臻囊瑗瞩醚壤鬟缀缓先心病室间隔缺损封堵治疗前后胸部X线表现陈金明姚睿荣廖德宁钱建英陈懿吴宗贵(第二军医大学长征医院心内科，上海200003)摘要：目的观察膜周部室间隔缺损(VSD)封堵术前后的胸部X线表现，总结封堵器在常规胸片上的影像特点。方法分析资料完整的33例AmplatzerVSD双面伞封堵VSD患者术前及术后4～7天内的胸部后前位及左侧位X线胸片。结果大部分VSD

2、患者封堵术后后前位胸片上封堵器位于第8～9椎体正中线的左侧，但形态上呈现1点、2点，偶可见1点1圈。侧位上封堵器均位于膈肌脊柱交叉点与胸骨角连线的左前方，多呈两点，部分呈“H”形。封堵术后短期内即出现肺部X线表现有不同程度的改善。结论正确安置的VSD封堵器在胸片上具有一定的显影特征．常规胸片可以用来判断VSD介入治疗的疗效以及封堵器的位置、形态。关键词：室间隔缺损；介入治疗；封堵器}胸部X线TheChestRadiographicAppearanceBeforeandafterTranscatheterClosureinPatientswith

3、VentricularSeptalDefectCHENJin-ming。YAORui—tong，LIAODe-ling，OJANJian-ying，CHEN玎，T矿UZong-ggi．(DepartmentofCardiology，ChangzhangHospital，Shanghai200003，P．R．China)Abstract：ObjectiveToexplorethechestradiographicappearanceofperi—membranousventricularseptaldefeCt(VSD)beforeandafte

4、rtranscatheterclosurewithAmplatzeroccluderandtoconcludetheradiographiccharacteristicsofVSDoccluderonchestradiography．MethodsPlainchestfilmsinposterior—anteriorviewandleftlateralviewwerestudiedin33patientsbeforeand4～7daysaftertranscatheterclosure．ResultsAftertheproceduremostV

5、SDoccluderswerelocatedbetweenT8andT9，leftofanteriormidlineonthepostero—anteriorroentgenogram．Theoccluderspresentedonedotortwodots。occasionallyonedotandonecircle．Onlateralchestradiographs，alloccluderslocatedtheleftanteriorofthelinebetweenthediaphragmandspinecrossingandthester

6、nalangle．Mostofoccluderspresentedtwodots。somewerelike“H”shape．Inmostpatients，thechestradiographicappearancewereimprovedtosomeextentaftertheprocedure．ConclusionTheventricularseptaldefectsoccludershaveacharacteristicradiographicappearancewhenproperlypositioned．Plainchestradiog

7、raphscanidentifytheeffectsoftranscatheterclosureandthelocationandshapeofoccludersinpatientswithVSD．Keywords：Ventricularseptaldefect；Interventionaltherapy，OccluderIRadiography室间隔缺损(VSD)为最常见的先天性心脏病之一，尽管外科手术的死亡率很低，但由于其创伤大、遗留手术疤痕及需要体外循环等原因，已逐渐被经导管介入封堵所取代。Amplatzer封堵器及类似的国产封堵器治疗已

8、成为膜部VSD的首选治疗手段[1]。术后随访是VSD封堵的重要组成部分，胸部X线检查为VSD介入治疗前后的重要检查，它不仅能够反映治疗前后肺部体征的变