CAJ | 학술논문

目的探讨左室-右房通道介入封堵治疗的可行性.方法采用国产室间隔缺损封堵器经导管介入治疗左室-右房通道22例.结果封堵成功21例,1例因植入封堵器后出现主动脉瓣反流而放弃.成功的21例心前区杂音均消失,术后超声心动图检查及随访期间超声心动图检查均示原缺损部位无残余分流,主动脉瓣无反流,术前存在三尖瓣反流者术后反流明显减轻,心电图检查示无房室传导阻滞或新的束支阻滞发生.本组选用对称型封堵器18枚,A4B2型封堵器3枚.结论应用导管技术介入封堵治疗左室-右房通道是可行的,但须尽可能选择完全匹配的封堵器型号,以避免房室传导阻滞、主动脉瓣反流和三尖瓣反流等并发症发生.
목적 탐토좌실-우방통도개입봉도치료적가행성.방법 채용국산실간격결손봉도기경도관개입치료좌실-우방통도22례.결과 봉도성공21례,1례인식입봉도기후출현주동맥판반류이방기.성공적21례심전구잡음균소실,술후초성심동도검사급수방기간초성심동도검사균시원결손부위무잔여분류,주동맥판무반류,술전존재삼첨판반류자술후반류명현감경,심전도검사시무방실전도조체혹신적속지조체발생.본조선용대칭형봉도기18매,A4B2형봉도기3매.결론 응용도관기술개입봉도치료좌실-우방통도시가행적,단수진가능선택완전필배적봉도기형호,이피면방실전도조체、주동맥판반류화삼첨판반류등병발증발생.
Objective To review and summarize the experiences of transcatheter closure of left ventricular-right atrium communication,and discuss the feasibility of interventional therapy for this kind of cardiac abnormalitis.Methods 22 patients who suffered from left ventricular-right atrium communication underwent transcatheter interventional therapy with ventricular septal defect(VSD) occluder.The operating procedures were performed as like as the transcatheter closure of VSD:established the pathway from femoral artery to femoral vein through left ventricle,VSD,right atrium (or from left ventricle to right atrial through the communication) and inferior vena cava,then inserted the polysheath from femoral vein,introduced by the pathway to left ventricle,and implanted VSD occluder through the polysheath to close the shunt.Results The operation succeeded in 21 patients.The cardiac murmur was disappeared in all patients,and there was no residual shunt or aortic regurgitation that conformed by postoperative ventriculography and echocardiography in follow up phase,and the tricuspid regurgitation was lessened than preoperative.The operation abort in 1 patient because of aortic regurgitation after implanting occluder.Conclusions Transcatheter closure of left ventricular-right atrium communication is feasible as the selected occluder is accordant,and atrioventricular block,aortic regurgitation and tricuspid regurgitation can be avoided.