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目的 :评价应用Amplatzer封堵器经导管治疗二孔型房间隔缺损 (ASD)的即刻疗效和超声心动图随访的近期效果。方法 :2 1例二孔型房间隔缺损患者 (男 12女 9,年龄 12～ 4 6岁 ) ,在透视及经食道超声心动图 (TEE)监视下采用Amplatzer封堵器封堵ASD ,TEE观察术后即刻封堵情况、经胸超声心动图 (TTE)比较术后 3d、1个月、6个月及 12个月心脏分流及心功能情况、术后并发症。结果 :除 1例因房间隔缺损太大 (大于 4 0mm)外 ,手术即刻成功率 10 0 % ,术中无任何严重并发症 ,10例病人球囊测得房间隔缺损直径 2 0～ 36mm ,选用封堵器直径 2 4～ 38mm ,术后即刻TEE检查示 3例存在微量残余分流 ,术后 3dTTE检查示 2例存在残余分流 ,6例病人完成 12个月随访 ,无 1例存在残余分流 ,无 1例封堵器脱落 ,X线检查示所有患者肺血减少 ,TTE检查示右心房、右心室缩小 ,心功能改善。结论 :经导管应用Amplatzer封堵器治疗二孔型ASD是一种安全、有效的非手术治疗方法 ,近、中期疗效可靠 ,值得临床推广应用
PURPOSE: To evaluate the immediate effect of transcatheter atrophy of secundum atrial septal defect (ASD) with Amplatzer occluder and follow-up of echocardiography. METHODS: Twenty-one patients with two-hole ASD (12 males and 12 females, aged 12 to 46 years) were enrolled in this study. Amplatzer occluders were used to block ASD under fluoroscopy and transesophageal echocardiography (TEE) Immediate postoperative occlusion of the situation, transthoracic echocardiography (TTE) compared 3d, 1 month, 6 months and 12 months after cardiac shunt and cardiac function, postoperative complications. Results: The success rate of surgery was 100% except for one case with atrial septal defect (more than 40 mm). There was no serious complication during operation. The diameter of atrial septal defect was 20 ~ 36 mm in 10 cases, The diameter of the occluder was 24 ~ 38mm. The TEE examination showed that there were 3 cases of residual residual shunt after operation. The 3 days after operation, there were 2 cases of residual shunt, and 6 cases completed 12 months of follow-up. No residual shunt was found in 1 case, No occluder occured in 1 case. X-ray examination showed decreased pulmonary blood flow in all patients. TTE showed right atrium and right ventricle narrowed and cardiac function improved. Conclusion: Transcatheter Amplatzer occluder is a safe and effective method for non-surgical treatment of two-hole ASD. It is worthy of clinical application