CAJ | 학술논문

目的评价Amplatzer肌部室间隔封堵器封堵室间隔穿孔(VSR)和同期经皮腔内冠状动脉成形术(PTCA)及冠脉支架术联合介入方法治疗急性心肌梗死(AMI)并发VSR的可行性及安全性.方法 6例患者术前均经超声心动图检查诊断为AMI并发心尖部VSR,出现心原性休克后均予主动脉球囊反搏(IABP)、机械通气支持.于3周后行室间隔封堵术,同期完成PTCA及支架术.结果 6例子Amplatzer肌部室间隔封堵器成功封堵VSR,2例有少量残余漏;同期冠状动脉造影3例患者为前降支中段及回旋支局限性狭窄,分别予植入1～2枚支架,另外3例患者为多支多段狭窄,未予以植入支架;3例并行支架的患者存活出院.结论应用Amplatzer肌部室间隔封堵器封堵VSR同期行PTCA及冠状动脉支架术治疗AMI并发VSR是安全可行的.
목적 평개Amplatzer기부실간격봉도기봉도실간격천공(VSR)화동기경피강내관상동맥성형술(PTCA)급관맥지가술연합개입방법치료급성심기경사(AMI)병발VSR적가행성급안전성.방법 6례환자술전균경초성심동도검사진단위AMI병발심첨부VSR,출현심원성휴극후균여주동맥구낭반박(IABP)、궤계통기지지.우3주후행실간격봉도술,동기완성PTCA급지가술.결과 6례자Amplatzer기부실간격봉도기성공봉도VSR,2례유소량잔여루;동기관상동맥조영3례환자위전강지중단급회선지국한성협착,분별여식입1～2매지가,령외3례환자위다지다단협착,미여이식입지가;3례병행지가적환자존활출원.결론 응용Amplatzer기부실간격봉도기봉도VSR동기행PTCA급관상동맥지가술치료AMI병발VSR시안전가행적.
Objective To evaluate the feasibility and safety of the treatment for ventricular septal rupture (VSR) by transcatheter interventional therapy coordinated with percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA).Methods Six patients who suffered from cardiogenic shock due to acute myocardial infarction (AMI) and VSR were given intra-aortic balloon pump (IABP) and mechanical ventilation support. After three weeks, they underwent transcatheter closure of ventricular septal rupture with Amplatzer ventricular septal occluder, and at the same time PCI and PTCA were performed. Results All the patients successfully underwent ventricular septal defect occlusion, including two cases of residual shunt. Segmental stenosis of the middle of anterior descending branch and circumflex artery were noted in three patients, and then stent implantation was used. The other three cases had multi-vessel lesion but were without stent implantation. All the patients with stent implantation survived and discharged. Conclusions It is safe and feasible to apply transcatheter closure of ventricular septal rupture with Amplatzer ventricular septal occluder, coordinated with PCI and PTCA for patients with acute myocardial infarction complicated with ventricular septal rupture.