欢迎来到天天文库
浏览记录
ID:5342169
大小:3.70 MB
页数:4页
时间:2017-12-08
《应用pda封堵器治疗嵴内型室间隔缺损的疗效及安全性分析》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、中国医学影像学杂志ChineseJournal。fMedica1Imaging。395。介入医学InterventionalMedicineDoi:10.3969/j.issn.1005—5185.2010.05.001【摘要】目的:评价应用PDA封堵器治疗嵴内型室间隔缺损(IVSD)的疗效及安全性。材料和方法:筛选适合经导管封堵治疗IVSD的患者2O例(男ll例女9例)。经彩色多谱勒超声心动图测量缺损口大小、距主动脉右冠瓣及肺动脉瓣距离,经皮穿刺股动脉和股静脉,建立动静脉轨道,经7~12F输送鞘管通过
2、右股静脉途径释放封堵器。结果:超声心动图测量的VSD直径5~7ram,平均6.5±0.5mm,大血管短轴切面上缺损位于12点至1点钟位,缺损上缘距主动脉瓣2~3mm,平均2.5±0.5mm。PDA封堵器的直径7~10mm,平均8.5士1.5mm,20例IVSD患者封堵全部成功,术后杂音消失或明显减弱(4/6级降至1~2/6级),左心室造影无分流现象,彩色多谱勒超声心动图检查无主动脉瓣返流,无穿膈血流。随访5个月~6年(平均36±12个月)未见穿隔血流、明显主动脉瓣返流以及传导阻滞等并发症。结论:PDA封
3、堵器可以成功封堵IVSD,近期疗效佳,无严重并发症的发生,远期疗效尚有待于进一步随访观察。【关键词】室间隔缺损,嵴内型;动脉导管未闭封堵器;放射摄影术,介人性[Abstract]PurposeToevaluatetheefficacyandsafetyofclosingintracristalyen—tricularseptaldefect(IVSD)withpatentductusartery(PDA)occluder.MaterialsandMethods20patients(11malesand9
4、females)withIVSDwereselectedfortreat—ment.Thedefectsize,itsdistancesbetweenaorticrightcoronarysinusvalveandpul—monaryvalveweremeasuredbycolorDopplertransthoracicech0cardiography(TTE).ThePDAoccluderswerereleasedthroughpercuteneousfemoralarteryandveinroute
5、.ResultsThediameterofIVSDwas6.5士0.5mm.ThedefectIocatedinthe12to1o~clockpositionontheshortaxisviewofgreatvessels.Thedistancesbe—tweenIVSDandaorticvalvewere2~3mm.ThediametersofPDAoccluderwere8.5±1.5mm.Theproceduresweresuccessfulon20patients.Aftertheprocedu
6、re,themurmurdisappearedorweakened,nosegregationonleftventricularangiography,noaorticvalveregurgitationornobloodflowthroughdiaphragmoncolorDopplerecho—cardiographyshowed.Nocomplicationwereobservedduringthefollow-upfrom5monthsto6years.ConclusionTranscathet
7、erclosureofIVSDwithPDAoccluderwaseffectiveandsafe,andnoseriouscomplicationoccurred,butneedfurtherevalua—tiononitslongtermefficacy.[KeyWords]heartseptaldefects,ventricular,intracristal;patentductusarteryOC—cluder;radiography,interventional先天性心脏病是一种常见病,室间隔
8、缺损(ven-1.5ram_4],嵴内型室问隔缺损(intracristalventriculartricularseptaldefect,VSD)发病率约占先天性心血管septaldefect,IVSD)位置较高,距主动脉右冠瓣很近,畸形的12~2O。近年来介人技术迅速发展,经导多数无距离,因而介入封堵有一定的难度和风险。国管VSD封堵术已成为部分VSD外科手术替代疗内外对IVSD的封堵治疗报道较少[5],而用动脉导管法l】],但VSD的
此文档下载收益归作者所有