经胸封堵术治疗室间隔缺损28例疗效分析

李炜; 周艳荣; 肖颖彬; 陈柏成; 郝嘉; 饶荣生; 陈林

doi:10.16016/j.1000-5404.201804111

您当前的位置：

首页 >

文章列表页 >

经胸封堵术治疗室间隔缺损28例疗效分析

临床医学 | 更新时间：2026-01-09

- 经胸封堵术治疗室间隔缺损28例疗效分析
- Occlusion of trans-thoracic minimal invasive surgery for septal ventricular defect: analysis for therapeutic effect in 28 cases
- 第三军医大学学报 2018年40卷第19期页码：1784-1787,1815
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院全军心血管外科
  2.400050 重庆，重庆市九龙坡区人民医院儿科
- 作者简介：
  
  [ 陈林，E-mail：chenlin_xq@aliyun.com CHEN Lin, E-mail: chenlin_xq@aliyun.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201804111
  中图分类号： R654.2;R726.5
- 收稿：2018-01-06，
  
  修回：2018-04-22，
  
  纸质出版：2018-10-15
- 稿件说明：
移动端阅览
李炜, 周艳荣, 肖颖彬, 等. 经胸封堵术治疗室间隔缺损28例疗效分析[J]. 第三军医大学学报, 2018,40(19):1784-1787,1815.

Wei LI, Yanrong ZHOU, Yingbin XIAO, et al. Occlusion of trans-thoracic minimal invasive surgery for septal ventricular defect: analysis for therapeutic effect in 28 cases[J]. Journal of Third Military Medical University, 2018, 40(19): 1784-1787,1815.
李炜, 周艳荣, 肖颖彬, 等. 经胸封堵术治疗室间隔缺损28例疗效分析[J]. 第三军医大学学报, 2018,40(19):1784-1787,1815. DOI： 10.16016/j.1000-5404.201804111.

Wei LI, Yanrong ZHOU, Yingbin XIAO, et al. Occlusion of trans-thoracic minimal invasive surgery for septal ventricular defect: analysis for therapeutic effect in 28 cases[J]. Journal of Third Military Medical University, 2018, 40(19): 1784-1787,1815. DOI： 10.16016/j.1000-5404.201804111.

摘要

目的

探讨经胸微创封堵术治疗室间隔缺损的手术经验及中期临床疗效。

方法

回顾性分析我科2013年8月至2016年8月收治的28例行微创封堵技术治疗室间隔缺损患者的病例资料，经1~3年的随访，复查本组病例心脏超声、胸部平片及心电图，总结手术经验并评价中期疗效。

结果

本组患者中男性13例，女性15例，年龄2岁零1个月至39(12.1±5.7)岁，体质量13~77 (31.8±1.6)kg。全部患者手术效果满意，无1例术中转开胸体外循环手术。2例患者术中超声提示腰部极少量分流，几天后复查消失，出院随访1~3年分流全部消失，无1例残余瘘发生，无1例传导阻滞发生，心脏大小恢复正常，心功能Ⅰ级。

结论

经胸微创封堵术是治疗室间隔缺损的一种安全、有效、微创的方法，通过中期临床随访有很好效果。

Abstract

Objective

To investigate the therapeutic effect of occlusion of transthoracic minimal invasive surgery in the treatment of ventricular septal defect (VSD).

Methods

Clinical data of 28 VSD patients undergoing above surgery in our center from August 2013 to August 2016 were collected and retrospectively analyzed. They all were followed for 1~3 years

and examined by echocardiography

chest plain filming and electrocardiography.

Results

The subjects were 13 males and 15 females

at a mean age of 12.1±5.7 (2~39) years

and with a weight of 131.8±1.6 (3~77) kg. All patients were satisfied with the clinical outcomes

and no one was transferred to open chest cardiopulmonary bypass. There were 2 cases with a small amount of shunt around waist by postoperative trans-esophageal echocardiography

and all of them disappeared several days later. No residual shunting of the occluder was observed in 1~3 years of follow-up. No atrioventricular block was observed in this series. Heart size was recovered to normal

and their cardiac function classification was NYHA 1.

Conclusion

Transthoracic minimally invasive closure is a safe

effective and minimally invasive surgery for VSD

with better clinical outcomes in medium-term follow-up.

关键词

Keywords

references

MINETTE M S, SAHN D J. Ventricular septal defects[J]. Circulation, 2006, 114(20): 2190-2197. DOI: 10.1161/CIRCULATIONAHA.106.618124.

ROSE E A. Off-Pump coronary artery bypass surgery[J]. N Engl J Med 2003, 348: 379-380. DOI: 10.1056/NEJMp020171.

KERN F H, HICKY P R. The effects of cardiopulmonary bypass on the brain. [M]//Jonas R A, ed. Cardiopulmonary bypass in neonates, infants and young children, 1st ed. Boston: Black-well Science, 1994: 263-278.

CARMINATI M, BUTERA G, CHESSA M, et al . Transcatheter closure of congenital ventricular sep-tal defect with Amplatzer septal occluders[J ] . Am J Cardiol 2005, 12; 96(12A): 52L-58L. DOI: 10 .1016/i.amjcard.2005.09.068.

Moodie DS. Technology insight: transcatheter closure of ventricular septal defects[J]. Nat Clin Pract Cardiovasc Med 2005; 2: 592-560. DOI: 10.1038/ncpcardio0351.

张玉顺, 李寰, 刘建平, 等.膜周部室间隔缺损介入治疗并发症的分析[J].中华儿科杂志, 2005, 43(1):35-38.

ZHANG Y S, LI H, LIU J P, et al . Complications of transcatheter interventional occlusion of ventricular septal defects[J ] . Chin J Pediatr, 2005, 43(1): 35-38.

BUTERA G, CARMINATI M, CHESSA M, et al .Transcatheter closure of perimem-branous ventricular septal defects: early and long-term results[J ] . J Am Coll Cardiol, 2007, 50: 1189- 1195.DOI: 10.1016/i.jacc.2007.03.068.

CARMINATI M, BUTERA G, CHESSA M, et al .Transcatheter closure of congenital ventricular septal defects: results of the European Registry[J ] . Eur Heart J, 2007, 28: 2361-2368.DOI: 10.1093/eurhearti/enm314

HOLZER R, BALZER D, CAO QL, et al .Device closure of muscular ventricular septal defects using the Amplatzer muscular ven-tricular septal defect occluder: immediate and mid-term resu lts of septal defect occluder: immediate and mid-term results of a U.S. registry[J ] . J Am Coll Cardiol, 2004, 43: 1257-1263.

QIN Y W, CHEN J M, ZHAO X X, et al .Transcatheter closure of perimembranous ventricular septal defect using a modified double-disk occluder[J ] . Am J Cardiol, 2008, 101: 1781-1786.DOI: 10.1016/i.amjcard.2008.02.069.

HIJAZI Z M, HAKIM F, HAWELEH A A, et al .Catheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: initial clinical experience[J ] . Catheter Cardiovasc Interv, 2002, 56: 508-515.DOI: 10.1002/ccd.10292.

FU Y C, BASS J, AMIN Z, et al .Transcatheter closure of perimembra-nous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase Ⅰ trial[J ] . J Am Coll Cardiol, 2006, 47: 319-325.DOI: 10.1016/i.jacc.2005.09.028.

BASS J L, ARORA R, TORRES, et al .(2003) Transcatheter closure of perimembranous VSDs with an eccentric Amplatzer device: initial human experience[J ] . Cathet Cardiovasc Intervent, 2003, 58(2): 238-245.

HIJAZI Z M, HAKI M F, FADLEY A L, et al .(2002) Transcatheter closure of single muscular ventricular septal defects using the Amplatzer muscular VSD occluder. Initial results and technical considerations[J ] . Cathet Cardiovasc Intervent, 2000, 2, 48(2): 167-172.

THANOPOULOS B D, KARANASSIOS E, TSAOUSIS G, et al . (2003) Catheter closure of congenital/acquired muscular VSDs and perimembranous VSDs using the Arnplatzer devices[J ] . J Inter-vent Cardiol, 2003, 10, 16(5): 399-407.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

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

两种抗凝方案下房间隔缺损封堵术后纤溶功能动态变化及意义