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題名 | Transcatheter Closure of Atrial Septal Defects with the Amplatzer Septal Occluder--Clinical Results=心導管方式關閉第二型心房中隔缺損之臨床結果 |
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作 者 | 黃大誠; 李正亮; 林竹川; 謝凱生; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 20:4 2004.12[民93.12] |
頁次 | 頁223-228 |
分類號 | 416.262 |
關鍵詞 | 心房中膈缺損; Amplatzer中膈關閉器; 心導管閉合術; Atrial septal defect; Amplatzer septal occluder; Transcatheter closure; |
語文 | 英文(English) |
中文摘要 | 背景 評估用心導管方式關閉第二型心房中隔缺損之短期臨床結果。方法 從2000年6月到2001年11月,共20位患第二型心房中隔缺損,治療的指標爲:其中18位病人患大型心房中隔缺損(患者Qp:Qs>1.5)經胸部心臓超音波顯示右心擴大及心室中隔運動異常,所有病人經追蹤至少半年至兩年(平均爲10個月)。結果 20位病患中,共19人接受心房中隔關閉器治療成功,成功率逹95%。一人接受手術治療,病人平均年齡爲10.1歲,男女比率爲1:1.5。平均Qp:Qs爲2.5±0.6(mean±S.D.)。食道心臓超音波測量心房中隔缺損的大小爲7到26.5公厘(平均值爲16.5±5.9公厘)。而經汽球沒量的大小爲8到29.5公厘(平均值爲19.4±6.5公厘)。所放置的心房中隔關閉器大小從9到34公厘。操作過程放射線透視時間從9.7到41.2公鍾(平均值爲23.2±9.0分鍾)。病人接受追蹤半年至兩年時間。結論 以心導管方式利用心房中隔關閉器治療心房中隔缺損爲一安全且有效的治療方法。經由慎選合適的病人,病人的心房中隔缺損可以不需手術而安全的加以閉合。 |
英文摘要 | Objective: To assess the short-term outcome following transcatheter closure of secundum atrial septal defect (ASD) in our hospital. Patients and Methods: Between June 2000 and November 2001, 20 patients diagnosed as secundum atrial septal defects underwent transcatheter closure of their defects using the Amplatzer septal occluder (ASO) device. Indications for 18 patients were larger atrial septal defects with Qp:Qs>1.5 and transthoracic echocardiography study revealing right heart dilatation and paradoxical interventricular septal motion. All patients were followed up for a period of 6 months to 2 years. Results: Nineteen ASO devices were successfully implanted in 20 patients. One patient was referred for surgery due to implantation failure. The success rate was 95%. The median age of the patients was 10.1 years. Male to female ratiowas 1:1.5. The mean Qp: Qs ratio was 2.5:1 The ASD sizewasmeasuredas 7-26.5mm(mean±SD; 16.5±5.9mm) on transoesophageal echocardiogram, and its diameter 8-29.5mm (19.4±6.5mm) using the balloon-stretched method. The implanted device size ranged from 9-34 mm. Fluoroscopy time for the procedure ranged from 9.7-41.2 minutes (23.2±9.0minutes). Follow-up periods ranged from 6 months to 2 years. No late complications have been found at follow-up visits. Conclusions: Transcatheter closure of secumdum ASDs with the Amplatzer septal occluder is a safe and effective alternative to surgery. With careful selection of patient group, secumdum ASDs can be successfully closed with minimal procedural morbidity and excellent result. Long-term follow up is necessary to compare the result with surgical closure. |
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