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目的探讨应用Amplatzer封堵器介入治疗先天性心脏病(CHD)动脉导管未闭(PDA)及房间隔缺损(ASD)的可行性并评价其疗效。方法44例CHD患者(PDA14例,ASD30例)。其中PDA患者在X线透视及造影监视下植入Amplatzer封堵器;ASD患者在X线透视及经胸超声心动图(TTE)指引下经导管植入Am-platzer封堵器。术后重复TTE、ECG、及X线平片检查以评价疗效。结果全组技术成功率100%。其中1例PDA患者术后2小时出现溶血,经内科保守治疗72小时后好转。术后随访显示肺动脉压力显著下降,PDA患者左心房(LA)、左心室舒张末期内径(LVED)及ASD患者右心室舒张末期内径(RVEDD)均明显回缩。除1例发生溶血的PDA患者6个月后仍存在少量残余分流外,其余病例均封堵完全;术后X线检查显示全部患者心胸比例不同程度缩小及肺血减少。结论应用Amplatzer封堵器经导管治疗PDA和ASD是一种安全简便、疗效可靠的介入治疗方法。
Objective To investigate the feasibility of using Amplatzer occluder for interventional treatment of patent ductus arteriosus (PDA) and atrial septal defect (ASD) in patients with congenital heart disease (CHD). Methods 44 cases of CHD patients (PDA14 cases, ASD30 cases). Among them, patients with PDA were implanted Amplatzer occluders under X-ray and contrast monitoring; ASD patients were transplanted Am-platzer occluder guided by X-ray and transthoracic echocardiography (TTE). Postoperative TTE, ECG, and X-ray examination to evaluate the efficacy. Results The overall technical success rate was 100%. One case of PDA patients with hemolysis 2 hours after surgery, conservative treatment after 72 hours improved. Postoperative follow-up showed a significant decrease in pulmonary artery pressure. Left atrium (LA), left ventricular end diastolic dimension (LVED), and right ventricular end-diastolic dimension (RVEDD) were all significantly reduced in PDA patients. Except for 1 patient with hemolytic PDA, there was still a small residual shunt after 6 months. The rest of the cases were completely occluded. X-ray examination showed that the proportion of cardiothoracic in all patients was reduced to varying degrees and pulmonary blood flow was reduced. Conclusions Transcatheter PDA and ASD using Amplatzer occluder is a safe, convenient and reliable interventional therapy.