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目的探讨应用国产零边偏心型封堵器治疗16例嵴内型室间隔缺损(IVSD)疗效及安全性。方法16例患者均经超声诊断为IVSD,经胸超声(TTE)大血管短轴观室间隔回声失落,且其分流束位于时钟11点半～1点钟之间,测得VSD距主动脉右冠瓣0～2(平均1.4±1.1)mm,VSD直径为3.5～12mm(平均6.4±4.6)mm,术中左心室造影测得VSD为4～14(平均6.5±4.8)mm,均应用国产零边偏心型封堵器(腰部直径6～14mm)。结果16例IVSD患者15例即刻封堵成功,成功率93.8%,2例术后即刻左室造影及超声检查少量残余分流,术后1周超声检查无残余分流,无主动脉瓣及房室瓣的反流。1例缺损过大,应用14mm封堵器不成功而放弃封堵治疗。术后1周心电监测无房室传导阻滞,术后1周至6个月复查经胸超声心动图,封堵器位置良好,无残余分流及主动脉瓣下反流,ECG无传导阻滞等特殊异常表现。结论应用国产零边偏心型封堵器介入治疗IVSD安全、疗效好,其远期疗效尚需长期临床观察。
Objective To explore the efficacy and safety of using domestic zero-margin eccentric occluder in the treatment of 16 cases of intracristal ventricular septal defect (IVSD). Methods 16 cases of patients were diagnosed by IVSD ultrasound, transthoracic echocardiography (TTE) short-axis ventricular septal echo loss, and the shunt at the clock 11:30 to 1 o’clock, measured VSD from the right aortic right The average size of the coronary arteries was 0 to 2 (average 1.4 ± 1.1) mm and VSD 3.5 to 12 mm (average 6.4 ± 4.6) mm respectively. Intravenous left ventricular angiography showed a VSD of 4 to 14 (mean, 6.5 ± 4.8) mm, Zero-edge eccentric occlusion device (waist diameter 6 ~ 14mm). Results Fifteen of 16 patients with IVSD were successfully occluded immediately, with a success rate of 93.8%. Two patients underwent immediate left ventricular angiography and ultrasonography to detect a small residual shunt. One week after operation, there was no residual shunt under ultrasound examination. No aortic valve and atrioventricular valve Reflux. 1 case of defect is too large, the application of 14mm occluder failed to give up the closure treatment. One week after surgery, there was no atrioventricular block in ECG, and transthoracic echocardiography was performed 1 week to 6 months after operation. The occluder was in good position with no residual shunt and aortic regurgitation, and ECG without conduction block And other special abnormalities. Conclusion The application of domestic zero-margin eccentric occluder interventional treatment of IVSD safety, good effect, the long-term efficacy still need long-term clinical observation.