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目的总结对先天性心脏病患者行介入治疗的临床经验,以提高介入治疗的成功率。方法48例先天性心脏病患者采用Cardiacure-TM封堵器行介入治疗,其中房间隔缺损(ASD)21例,动脉导管未闭(PDA)12例,室间隔缺损(VSD)12例,ASD合并PDA1例,VSD合并PDA2例。结果全组患者无死亡,一次性封堵成功44例,介入封堵治疗成功率为91.7%(44/48);15例次PDA患者介入封堵治疗成功率为100%(15/15);22例次ASD患者成功率为90.9%(20/22),14例次VSD患者成功率为85.7%(12/14)。封堵伞于术中脱落3例,其中ASD伞脱落2例,VSD伞脱落1例;介入治疗未成功1例。4例封堵未成功的患者中3例择期行体外循环修补手术治愈,1例行急诊体外循环修补手术治愈。随访40例,随访时间1～19个月,复查心脏杂音消失,心脏彩色超声心动图提示无残余分流。结论介入治疗是治疗先天性心脏病的有效方法,心胸外科医师掌握该项技术有其较多的优势。
Objective To summarize the clinical experience of interventional therapy in patients with congenital heart disease in order to improve the success rate of interventional therapy. Methods Forty-eight patients with congenital heart disease were treated with Cardiacure-TM occluder. Among them, 21 cases had atrial septal defect (ASD), 12 cases had patent ductus arteriosus (PDA), 12 cases had ventricular septal defect (VSD) PDA1 cases, VSD PDA2 cases. Results There were no deaths in all the patients. One - time occlusion was performed successfully in 44 cases. The success rate of interventional occlusion was 91.7% (44/48). The success rate of interventional occlusion in 15 cases of secondary PDA was 100% (15/15). The success rate of 22 patients with ASD was 90.9% (20/22), and the success rate of 14 patients with VSD was 85.7% (12/14). There were 3 cases of occlusion of umbrella in operation, including 2 cases of ASD umbrella shedding and 1 case of VSD umbrella shedding. One case was unsuccessful in interventional therapy. Of the 4 patients with unsuccessful occlusion, 3 patients underwent elective cardiopulmonary bypass and 3 patients underwent elective cardiopulmonary bypass. Follow-up 40 cases, followed up for 1 to 19 months, recurred heart murmur disappeared, heart color echocardiography prompted no residual shunt. Conclusion Interventional therapy is an effective method for the treatment of congenital heart disease. Cardiothoracic surgeons have more advantages in mastering this technique.