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目的:通过对多孔型房间隔缺损(ASD)进行经导管封堵治疗,探讨多孔型ASD介入治疗的适应证及注意事项。 方法:先经心脏超声检查确诊为多孔型ASD,后在局部麻醉下用测量球囊进行试封堵,同时用心脏超声检测试封堵时两ASD闭合情况及孔间距,并确定置入封堵器数量及大小,术后用心脏超声进行随访观察。 结果:全组6例双孔型ASD患者中2例分别置入2个封堵器,4例置入1个封堵器。术后随访1个月至2年,4例无残余分流,1例随访2年虽仍有少许残余分流,但自觉症状好转,心影缩小。另1例术后1个月因残余分流而被迫手术取出。 结论:经导管封堵成人多孔型ASD安全、有效,对两ASD相距较远者应放置2个封堵器,对两ASD相距较近者则可用1个封堵器封堵。
Objective: To investigate the indications and precautions of percutaneous ASD interventional therapy by transcatheter closure of porous atrial septal defect (ASD). Methods: The first ASD was diagnosed as pleural ASD. After the local anesthesia, the test balloon was used for blocking test. At the same time, the closure of the two ASDs and the distance between the two ASDs were determined by echocardiography. The number and size of the devices were followed up by echocardiography. Results: Two occluders were placed in two cases and one occluder in four cases. All cases were followed up for 1 month to 2 years. There were no residual shunts in 4 cases. Although there was still a little residual shunt in 1 case, the symptoms improved and the heart shadow reduced. Another case of 1 month after surgery due to residual shunt was forced to remove. CONCLUSION: Transcatheter closure of adult porous ASD is safe and effective. Two occluders should be placed at a distance from the two ASDs. One occluder can be used to close the two ASDs.