| 摘要: |
| 目的:评价40岁以上患者房间隔缺损(ASD)介入治疗的疗效和安全性。方法:1998年10月至2005年7月于我院行房间隔缺损封堵术的115例40岁以上患者入选本研究。单一ASD 106例,合并卵圆孔未闭1例,多孔型8例。使用美国AGA Amplatzer及国产ASD封堵器。所有患者在术前、术后3 d行12导联心电图(ECG)、胸片和经胸超声心动图(TTE)检查,术后6个月和3年进行随访。结果:115例患者成功介入114例,1例封堵失败转胸外科行ASD修补术,介入成功率99.13%,手术并发症总发生率3.5%(4/115)。心功能有明显改善,ECG右束支传导阻滞(RBBB)消失或改善(完全RBBB变为不完全RBBB),胸片心胸比值明显缩小,TTE改变主要是右室(RV)容积缩小及射血分数(EF)提高,残余漏3例,均为微量穿隔血流。结论:只要掌握好手术适应证,ASD介入治疗对于40岁以上患者来说仍是安全可靠的。 |
| 关键词: 房间隔缺损 40岁以上成年人 心脏导管插入术 随访 疗效 |
| DOI：10.3724/SP.J.1008.2009.00061 |
| 投稿时间：2008-07-23修订日期：2008-10-31 |
| 基金项目: |
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| Transcatheter closure of secundum atrial septal defects in patients aged over 40: a follow-up of outcome |
| YU Man-li ,WANG Jia-feng,LIU Jing,QIN Yong-wen*,WANG Ke,ZHAO Xian-xian,WU Hong,HUANG Xin-miao |
| (Department of Cardiovasology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China) |
| Abstract: |
| Objective:To evaluate the safety and effectiveness of transcatheter closure of secundum atrial septal defects (ASD) in patients aged over 40 years old.Methods: A total of 115 patients with secundum ASD,aged 40 or over,who were treated by transcatheter closure in our hospital from Oct.1998 to Jul.2005,were enrolled in this study,including 106 with single ASD,eight with multiple ASD and one with complicated patent foramen ovale.All the 115 patients received ASD closure with the AGA Amplatzer device or ASD occluder made in China.The patients received electrocardiogram (ECG),X-ray and transthoracic echocardiography (TEE) before and three days after operation.Follow-up were done 6 months and 3 years after operation.Results: The transcatheter procedure was successfully done in 114 (99.13%) of the 115 patients.The one failed case was transferred to the thoracic surgery department for ASD repair.The complication rate was (3.5%).Classification of heart function (NYHA) improved from 2.11±0.78 to 1.34±0.56 after operation (P<0.001).ECG showed that the right bundle branch block (RBBB) disappeared or improved (complete RBBB to incomplete RBBB).X-ray showed a decrease of cordis/thorax ratio (CTR).TTE displayed that the right venticle (RV) volume was significantly decreased (P<0.001) and ejection fraction was significantly increased (P<0.001).There were three cases of transseptal residual leakage.Conclusion: Transcatheter closure of secundum ASD in patients aged over 40 is safe and effective when indications are strictly followed. |
| Key words: atrial septal defect 40 and over adult heart catheterization follow-up outcome |
