CAJ | 학술논문

目的分析室间隔缺损介入封堵失败病例,提高术前超声心动图筛选患者的手术成功率.方法对50例室间隔缺损介入封堵手术失败患者的超声心动图检查结果进行分析.结果 14例术中出现房室传导阻滞,13例术后有残余分流,19例无法建立封堵轨道,2例嵴内置人封堵器后出现较明显的主动脉瓣反流,1例冠心病、1例急性心肌梗死伴室间隔穿孔,以上患者均未能完成手术.结论应用超声心动图注意观察室间隔缺损的左右室侧大小及周边结构.对年龄较小、缺损复杂或年龄较大合并冠心病的患者,应慎用封堵方法.
목적 분석실간격결손개입봉도실패병례,제고술전초성심동도사선환자적수술성공솔.방법 대50례실간격결손개입봉도수술실패환자적초성심동도검사결과진행분석.결과 14례술중출현방실전도조체,13례술후유잔여분류,19례무법건립봉도궤도,2례척내치인봉도기후출현교명현적주동맥판반류,1례관심병、1례급성심기경사반실간격천공,이상환자균미능완성수술.결론 응용초성심동도주의관찰실간격결손적좌우실측대소급주변결구.대년령교소、결손복잡혹년령교대합병관심병적환자,응신용봉도방법.
Objective To analyse the failure reason in transcatheter closure of ventricular septal defect(VSD) ,in order to improve the succeeding rate of occlusive operation on screening VSD patients with echocardiography. Methods Echocardiographic datas were summarized in 50 cases who were failed in VSD occlusion. Results Atrio-ventricular block was occurred in 14 patients,residual shunt was visualized in 13 cases,transcatheter occlusive track could not be set up in 19 cases,arotic valve regurgitation in two cases were screened obviously after occlusive device was released into the intracristal VSD. One case was suffered from cononary heart disease(CAD) and another one was suffered from acute myocardial infarction with ventricular septal perforation. All these patients did not succeed in closure procedure. Conclusions The defect sizes of left and right sides of ventricular septal, structure close to defect must be considered in selecting patients before operation by echocardiography. Occlusion operation should be strictly chosen in cases who were children,or suffered from complex VSD,or senior patients with CAD.