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目的总结苏州大学附属儿童医院经导管室间隔缺损封堵术治疗儿童室间隔缺损(ventrical septaldefect,VSD)的实践,分析其适应症的选择及临床疗效。方法分析2004年8月—2010年8月,共25例室间隔缺损患儿接受了Amplatzer封堵器经导管介入治疗术,其中成功25例,男16例,女9例;年龄3~14岁,平均年龄(6.513±3.35)岁。经胸超声心动图(transthoracic echocardio gra-phy,TTE)提示:VSD的平均直径(5.38±1.78mm)(3.5~9mm),随访复查心脏超声、心电图和胸片。结果 25例患儿封堵器置入成功,技术成功率为92.6%。术后出现微量残余分流1例(<1.5mm),轻微和轻度主动脉瓣膜返流各1例,间歇性高度-完全性房室传导阻滞伴阿斯综合征反复发作1例,交界性逸搏心律1例。结论经导管介入治疗膜周部VSD,近期效果良好,具有较好的安全性;但其中、远期疗效的评价尚需扩大样本量和多中心的研究评价。
Objective To summarize the practice of transcatheter ventricular septal defect occlusion in children’s hospital affiliated to Soochow University in treating children with ventricular septaldefect (VSD). The choice of indications and clinical curative effect were analyzed. Methods From August 2004 to August 2010, 25 patients with ventricular septal defect underwent transcatheter closure of Amplatzer occluder. Among them, 25 were successful, 16 were males and 9 were females; the age ranged from 3 to 14 years , The average age (6.513 ± 3.35) years old. Transthoracic echocardio gra-phy (TTE) showed that the average diameter of VSD was (5.38 ± 1.78mm) (3.5-9mm). The echocardiogram, ECG and chest radiography were followed up. Results 25 cases of occluder implantation in children, the technical success rate was 92.6%. One case (<1.5mm) of residual residual shunt after operation, one case of mild and mild aortic valve regurgitation, one case of intermittent altitude-complete atrioventricular block with recurrent Asperger’s syndrome, borderline 1 case of escape rhythm. Conclusions Transcatheter interventional therapy of peri-ventricular VSD has good short-term effect and good safety. However, the evaluation of long-term efficacy needs to expand the sample size and multicentre research evaluation.