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目的评价房间隔瘤(ASA)并发继发孔型房间隔缺损(ASD)介入治疗的可行性、安全性及疗效。方法全组13(男5,女8)例,年龄10～54(27.6±15.3)岁。经临床、X线及经胸超声心动图(TTE)检查确诊为ASA并发继发孔型ASD。TTE检查ASA均膨入右心房,ASD最大直径10～27(17.4±6.5)mm。其中单孔ASD8例,多孔ASD5例,孔间距离1～7mm者4例,9mm者1例。结果13例均一次封堵成功,技术成功率100%。所用封堵器的直径为16～38(24.3±8.2)mm。5例多孔ASD,有4例置入1个封堵器直接封堵多个缺损孔,1例(两个缺损孔之间距离为9mm)分别用20mm和16mm两个封堵器封堵。术后即刻TTE检查显示13例均获完全闭合,无残余分流。3～6个月复查11例(84.6%)心脏大小恢复正常,2例(15.4%)心脏不同程度的缩小,无封堵器移位及其他并发症。结论介入治疗房间隔瘤(ASA)并发继发孔型ASD是可行、安全的,可以获得良好的封堵效果。
Objective To evaluate the feasibility, safety and efficacy of atrial septal defect (ASA) complicated with secundum atrial septal defect (ASD) interventional therapy. Methods The whole group of 13 (5 men and 8 women) cases, aged 10 to 54 (27.6 ± 15.3) years. Clinical, X-ray and transthoracic echocardiography (TTE) examination confirmed ASA complicated with secondary ASD. TTE ASA were swollen into the right atrium, ASD maximum diameter of 10 ~ 27 (17.4 ± 6.5) mm. There were 8 cases of single-hole ASD, 5 cases of porous ASD, 4 cases of distance 1 ~ 7mm between holes, and 1 case of 9mm. Results All the 13 cases were successfully occluded and the technical success rate was 100%. The occluder used is 16 to 38 (24.3 ± 8.2) mm in diameter. 5 cases of porous ASD, 4 cases of an occluder placed directly blocking multiple defect holes, 1 case (the distance between the two defect holes 9mm) were occluded with two occluders 20mm and 16mm respectively. TTE immediately after the operation showed that 13 cases were completely closed, no residual shunt. From 3 to 6 months, 11 cases (84.6%) had normal heart size, 2 cases (15.4%) heart reduced to varying degrees, no occluder displacement and other complications. Conclusion Interventional treatment of atrial septal defect (ASA) with secondary perforation ASD is feasible and safe, and can obtain a good blocking effect.