中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2011年
11期
993-996
,共4页
陈火元%朱鲜阳%韩秀敏%侯传举%张端珍%王琦光%盛晓棠%崔春生
陳火元%硃鮮暘%韓秀敏%侯傳舉%張耑珍%王琦光%盛曉棠%崔春生
진화원%주선양%한수민%후전거%장단진%왕기광%성효당%최춘생
房间隔缺损%老年人%心脏导管插入术
房間隔缺損%老年人%心髒導管插入術
방간격결손%노년인%심장도관삽입술
Heart septal defects,atrial%Aged%Heart catheterization
目的 探讨老年房间隔缺损患者的临床特征及行经导管封堵治疗的安全性和有效性.方法 入选2000年5月至2010年6月行经导管封堵治疗的(64.5±3.8)岁房间隔缺损患者82例.经导管封堵术中行右心导管检查.术后1d、1个月、3个月和6个月进行随访.分析老年房间隔缺损患者的临床特征,观察房间隔缺损封堵前后肺动脉压及心功能的改变情况.结果 82例房间隔缺损患者中,合并肺动脉高压37例,发生率为45.1％.封堵前的右心导管检查显示,患者肺动脉收缩压为(44.1±12.4)mm Hg(1 mm Hg=0.133 kPa),肺动脉平均压为(25.2 +6.8)mm Hg.1例重度肺动脉高压患者不适宜经导管封堵治疗,其余81例均成功行介入治疗,无手术相关并发症.36例封堵成功的肺动脉高压患者肺动脉收缩压由术前的(52.7±10.3)mm Hg下降至术后的(31.8 +6.3)mm Hg(P＜0.05),肺动脉平均压由术前的(30.9±4.7) mm Hg下降至术后的(21.8±3.4) mm Hg(P＜0.05).与术前比较,术后1d、1个月、3个月和6个月NYHA心功能分级改善.术后新发心房颤动6例.结论 老年房间隔缺损患者通常合并肺动脉高压.只要严格掌握适应证和规范操作,经导管封堵治疗老年房间隔缺损仍是一种安全有效的方法.
目的 探討老年房間隔缺損患者的臨床特徵及行經導管封堵治療的安全性和有效性.方法 入選2000年5月至2010年6月行經導管封堵治療的(64.5±3.8)歲房間隔缺損患者82例.經導管封堵術中行右心導管檢查.術後1d、1箇月、3箇月和6箇月進行隨訪.分析老年房間隔缺損患者的臨床特徵,觀察房間隔缺損封堵前後肺動脈壓及心功能的改變情況.結果 82例房間隔缺損患者中,閤併肺動脈高壓37例,髮生率為45.1％.封堵前的右心導管檢查顯示,患者肺動脈收縮壓為(44.1±12.4)mm Hg(1 mm Hg=0.133 kPa),肺動脈平均壓為(25.2 +6.8)mm Hg.1例重度肺動脈高壓患者不適宜經導管封堵治療,其餘81例均成功行介入治療,無手術相關併髮癥.36例封堵成功的肺動脈高壓患者肺動脈收縮壓由術前的(52.7±10.3)mm Hg下降至術後的(31.8 +6.3)mm Hg(P＜0.05),肺動脈平均壓由術前的(30.9±4.7) mm Hg下降至術後的(21.8±3.4) mm Hg(P＜0.05).與術前比較,術後1d、1箇月、3箇月和6箇月NYHA心功能分級改善.術後新髮心房顫動6例.結論 老年房間隔缺損患者通常閤併肺動脈高壓.隻要嚴格掌握適應證和規範操作,經導管封堵治療老年房間隔缺損仍是一種安全有效的方法.
목적 탐토노년방간격결손환자적림상특정급행경도관봉도치료적안전성화유효성.방법 입선2000년5월지2010년6월행경도관봉도치료적(64.5±3.8)세방간격결손환자82례.경도관봉도술중행우심도관검사.술후1d、1개월、3개월화6개월진행수방.분석노년방간격결손환자적림상특정,관찰방간격결손봉도전후폐동맥압급심공능적개변정황.결과 82례방간격결손환자중,합병폐동맥고압37례,발생솔위45.1％.봉도전적우심도관검사현시,환자폐동맥수축압위(44.1±12.4)mm Hg(1 mm Hg=0.133 kPa),폐동맥평균압위(25.2 +6.8)mm Hg.1례중도폐동맥고압환자불괄의경도관봉도치료,기여81례균성공행개입치료,무수술상관병발증.36례봉도성공적폐동맥고압환자폐동맥수축압유술전적(52.7±10.3)mm Hg하강지술후적(31.8 +6.3)mm Hg(P＜0.05),폐동맥평균압유술전적(30.9±4.7) mm Hg하강지술후적(21.8±3.4) mm Hg(P＜0.05).여술전비교,술후1d、1개월、3개월화6개월NYHA심공능분급개선.술후신발심방전동6례.결론 노년방간격결손환자통상합병폐동맥고압.지요엄격장악괄응증화규범조작,경도관봉도치료노년방간격결손잉시일충안전유효적방법.
Objective To evaluate the clinical feature of patients with atrial septal defects (ASD)and the safety and efficacy of transcatheter closure of ASD in elderly patients.Methods Between May 2000and June 2010,82 patients aged (64.5 + 3.8)years underwent attempted transcatheter ASD closure.Right heart catheterization was performed before intervention.Echocardiography was made at 1 day,1,3,6 months after the procedure.The pre- and post-closure clinical feature,pulmonary artery pressure (PAP) and cardiac function were evaluated.Results In 82 patients,37 (45.1％) patients were associated with pulmonary arterial hypertension ( PAH ).The systolic PAP and mean PAP [ (44.1 ± 12.4) mm Hg ( 1mm Hg = 0.133 kPa) and (25.2 + 6.8) mm Hg,respectively ] were measured by right heart catheterization before the procedure.One patient was unsuitable for closure because of severe PAH.The remaining 81patients underwent successful ASD closure without major complications.After closuring,systolic PAP decreased from (52.7 ± 10.3 )mm Hg to (31.8 ± 6.3) mm Hg ( P ＜ 0.05 ),and mean PAP descended from (30.9 ± 4.7 ) mm Hg to (21.8 ± 3.4) mm Hg( P ＜ 0.05 ) in the 36 patients with PAH.The cardiac function improved post procedure.There were 6 new-onset atrial fibrillations during follow up.Conclusions ASD in elderly patients are commonly associated with PAH.Transcatheter ASD closure is safe and effective in the majority of elderly patients.
