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马进举,姚青,宋治远,仝识非,景涛,李永华,张倩,张志辉,李华康,刘锋.膜周部室间隔缺损经导管封堵术后三尖瓣反流的发生与转归[J].陆军军医大学学报(原第三军医大学学报),2013,35(12):1294-1296.
Ma Jinju,Yao Qing,Song Zhiyuan,Tong Shifei,Jing Tao,Li Yonghua,Zhang Qian,Zhang Zhihui,Li Huakang,Liu Feng.Occurrence and outcome of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defect[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(12):1294-1296.
马进举,姚青,宋治远,仝识非,景涛,李永华,张倩,张志辉,李华康,刘锋.膜周部室间隔缺损经导管封堵术后三尖瓣反流的发生与转归[J].陆军军医大学学报(原第三军医大学学报),2013,35(12):1294-1296. DOI:
Ma Jinju,Yao Qing,Song Zhiyuan,Tong Shifei,Jing Tao,Li Yonghua,Zhang Qian,Zhang Zhihui,Li Huakang,Liu Feng.Occurrence and outcome of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defect[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(12):1294-1296. DOI:
目的 探讨膜周部室间隔缺损(perimembranous ventricular septal defect,PMVSD)经导管封堵术后三尖瓣反流的发生与转归。 方法 选取2007年1月至2012年3月在我院心内科诊断为PMVSD并成功行经导管介入封堵治疗的患者332例,其中男182例,年龄(15.4±12.3)岁。分别在经导管封堵术前、术后3天及1、3、6、12个月行经胸超声心动图(transthoracic echocardiography,TTE)检查,观察有无三尖瓣反流及其程度。并根据所用封堵器类型分为2组:对称型封堵器组和细腰型封堵器组,并比较两组三尖瓣反流的发生率。 结果 332例患者中181例使用对称型封堵器,另151例使用细腰型封堵器。术后共有14例(4.2%)新出现三尖瓣反流或原有三尖瓣反流加重,其中对称型封堵器组8例(4.4%),细腰型封堵器组6例(4.0%),二者之间无明显差异(
P
=0.84);随访时间(12.1±7.9)个月,有3例患者三尖瓣反流程度较出院时减轻。无因三尖瓣腱索断裂或瓣膜毁损导致三尖瓣关闭不全的患者。 结论 PMVSD经导管封堵术后少数患者可发生三尖瓣反流,其发生与封堵器类型无关,反流程度一般不随时间推移而加重,预后较好。
Objective To investigate the occurrence and outcome of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defect (PMVSD). Methods From January 2007 to March 2012
332 patients diagnosed as PMVSD and successfully underwent transcatheter interventional therapy in the Southwest Hospital were enrolled
including 182 male patients with an average age of 15.4±12.3 years. Transthoracic echocardiography (TTE) was applied to observe the tri
cuspid regurgitation and its degree before procedure
in 3 d after procedure
and during 1-
3-
6- and 12-month follow-up. The patients were divided into two groups based on the devices applied: a symmetric occluder group and a small-waist occluder group
and the incidence of tricuspid regurgitation in the two groups were compared. Results In the 332 patients
181 patients used the symmetric occluders and 151 patients used the small-waist occluders. After procedure
new tricuspid regurgitation or aggregation of primary tricuspid regurgitation were observed in 14 patients (4.2%). There were 8 patients (4.4%) in the symmetric occluder group and 6 patients (4.0%) in the small-waist occluder group
and the difference between the two groups was no statistically significant (
P
=0.84). During the follow-up for (12.1±7.9) months on average
3 patients’ tricuspid regurgitation mitigated. There was no tricuspid regurgitation induced by tricuspid chordae fracture or valve damage. Conclusion After transcatheter closure of PMVSD
a small number of patients may develop tricuspid regurgitation
which is unrelated to the types of occluders. The regurgitation generally does not aggravate over time
and the outcome is good.
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