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为探讨Amplatzer房间隔封堵器 (ASO)在儿童中的应用限度 ,并进行方法学评价 ,共有68例符合手术指征的继发孔型ASD患儿接受了经导管ASO封堵术。术中经右上肺静脉造影、经食道超声心动图 (TEE)测量ASD位置、大小及周围关系 ,并以扩张球囊测量ASD伸展直径 ,按此选择等于或大于其1mm～2mm的封堵器 ;对于>25mm伸展直径的ASD或房缺主动脉根部前缘缺如的ASD ,所选ASO应大于其2mm～4mm。房缺前缘近主动脉根部的缺如并不影响装置的成功放置 ,但房缺后上缘是否有足够距离对手术的成功是决定性的。手术操作按常规进行。术后即刻行TEE或TTE检查观察治疗效果 ,此后定期检查评价疗效。结果68例患儿ASD术前TEE直径 (13.26±4.74)mm ,球囊伸展直径 (15.96±5.44)mm ,选用封堵器腰部直径 (10～32)mm,平均 (16.35±5.81)mm。68例均一次手术封堵成功 ,技术成功率100 % ;65例术后即刻TEE/TTE检查示完全封堵无分流 ,完全封堵率95.6% ;3例术后发生无血液动力学意义的少量残余分流 ,残余分流率4.4 % ,2例24小时后TTE复查分流消失 ,1例1年后消失。除2例装置释放后曾出现一过性房性早搏 (2.9 %)外 ,无其它并发症发生。结果表明虽然ASO对堵塞继发孔型房缺安全有效、无并发症、无死亡率、装置结构简单、操作方便、可多次回撤与重新?
To explore the limitations of Amplatzer ASO in pediatric patients and conduct a methodological evaluation, a total of 68 children with ASD with surgical indications underwent ASO closure. During the operation, ASD position, size and surrounding area were measured by transesophageal echocardiography (TEE) during the operation. The diameter of ASD was measured by dilatation balloon, and the occluder whose ASD was equal to or greater than 1mm ~ 2mm was selected; ASD> 25mm diameter extension of the aortic root atrial septal absence of ASD, the selected ASO should be greater than 2mm ~ 4mm. The absence of the proximal aorta at the anterior margin of the atrium does not affect the successful placement of the device, but whether the superior margin of the atrial appendage has a sufficient distance is decisive for the success of the procedure. Surgical procedures as usual. Immediate postoperative TEE or TTE examination to observe the effect of treatment, then regularly evaluate the evaluation. Results The mean preoperative TEE diameter was (13.26 ± 4.74) mm and the balloon diameter was (15.96 ± 5.44) mm in 68 ASD patients. The diameter of occluder was 10 ~ 32 mm (average 16.35 ± 5.81) mm. Sixty-eight patients were successful in one operation, and the technical success rate was 100%. Sixty-five TEE / TTE tests showed complete occlusion without shunt after operation, with a complete occlusion rate of 95.6%. A small amount of hemodynamics Residual shunt, the residual shunt rate of 4.4%, 2 cases TTE 24 hours after the shunt disappeared, 1 case disappeared after 1 year. No other complication occurred except for atrial premature beats (2.9%) after 2 devices were released. The results showed that although ASO plug the secondary orifice of the room safe and effective, no complications, no mortality, the device structure is simple, easy to operate, multiple retractions and re-?