CAJ | 학술논문

目的探讨先天性心脏病复合畸形经导管同期介入治疗的可行性、治疗策略和疗效.方法 2006年11月至2013年9月介入治疗先天性心脏病复合畸形共17例.先天性心脏病的复合畸形为室间隔缺损(VSD)并发房间隔缺损(ASD)7例,ASD并发动脉导管未闭(PDA)3例,ASD并发肺动脉瓣狭窄(PS)2例,VSD并发PDA 5例.介入治疗的顺序依次为肺动脉瓣球囊扩张术(PBPV)、VSD封堵术、PDA封堵术,最后行ASD封堵术.术后48 h,1～6个月随访检查心电图、X线胸片和超声心动图.结果 17例复合畸形均一次性治疗成功,手术成功率100％.并发症发生率5.9％ (1/17),1例VSD并ASD术后发生残余分流伴溶血经治疗后停止,余随访无不良并发症发生.结论严格掌握适应证,术中采取适当的治疗策略,操作规范,先天性心脏病复合畸形的同期介入治疗安全可行、有效,可获得满意的效果.
목적 탐토선천성심장병복합기형경도관동기개입치료적가행성、치료책략화료효.방법 2006년11월지2013년9월개입치료선천성심장병복합기형공17례.선천성심장병적복합기형위실간격결손(VSD)병발방간격결손(ASD)7례,ASD병발동맥도관미폐(PDA)3례,ASD병발폐동맥판협착(PS)2례,VSD병발PDA 5례.개입치료적순서의차위폐동맥판구낭확장술(PBPV)、VSD봉도술、PDA봉도술,최후행ASD봉도술.술후48 h,1～6개월수방검사심전도、X선흉편화초성심동도.결과 17례복합기형균일차성치료성공,수술성공솔100％.병발증발생솔5.9％ (1/17),1례VSD병ASD술후발생잔여분류반용혈경치료후정지,여수방무불량병발증발생.결론 엄격장악괄응증,술중채취괄당적치료책략,조작규범,선천성심장병복합기형적동기개입치료안전가행、유효,가획득만의적효과.
Objective To investigate the feasibility,therapeutic tactic and efficiency of simultaneous transcatheter therapy on combined congenital heart diseases.Methods Seventeen patients hospitalized from November 2006 to September 2013 with combined congenital heart diseases were selected as our subjects,and they included 7 cases with ventricular septal defects(VSD) and atrial septal defects(ASD),5 cases with VSD and patent ductus arteriosus(PDA),3 cases with ASD and PDA,2 cases with ASD and pulmonary stenosis(PS) They underwent transcatheter therapy simultaneously with the sequential algorithm as percutaneous balloon pulmonary valvuloplast y (PBPV) at first stage and then followed by the occlusion of VSD,PDA,ASD successively.Transthoracic echocardiography (TTE),X-ray examination and electrocardiogram (ECG) were performed at 48 h,1-6 months after the procedure to evaluate the outcome of the procedure.Results All patients were cured and the cure rate was 100％.The complication rate was 5.9％ (1/17).One case with VSD and ASD showed a small residual shunt with hemolysis at 6 hours later after operation and it disappeared at 14 days after operation through medicine therapy.No other complication occurred in follow-up periods.Conclusion Simultaneous transcatheter therapy of combined congenital heart diseases is feasible,safe and effective with satisfactory good results through strict indication selection,appropriate therapeutic tactics and standardized manipulations