CAJ | 학술논문

目的探讨经胸壁微创室间隔缺损(VSD)封堵术对膜周部室间隔缺损(PVSD)的治疗效果及安全性.方法 2011年1月至12月,治疗129例PVSD患者(儿),男60例,女69例；年龄9个月～57岁.PVSD直径1.4～9.0 mm,均经胸骨中下1/3段3～5 cm正中小切口行微创VSD封堵术.术后密切随访观察,定期复查超声心动图和心电图.结果 114例封堵成功,15例术中转体外循环下行VSD修补术.其中应用等边封堵伞96枚,偏心封堵伞20枚.术后随访期间均无严重并发症发生.结论经胸壁微创VSD封堵术治疗PVSD的近期治疗效果满意,具有良好的应用前景.目前尚缺乏长期的随访资料,有待进一步的随访观察.
목적 탐토경흉벽미창실간격결손(VSD)봉도술대막주부실간격결손(PVSD)적치료효과급안전성.방법 2011년1월지12월,치료129례PVSD환자(인),남60례,녀69례；년령9개월～57세.PVSD직경1.4～9.0 mm,균경흉골중하1/3단3～5 cm정중소절구행미창VSD봉도술.술후밀절수방관찰,정기복사초성심동도화심전도.결과 114례봉도성공,15례술중전체외순배하행VSD수보술.기중응용등변봉도산96매,편심봉도산20매.술후수방기간균무엄중병발증발생.결론 경흉벽미창VSD봉도술치료PVSD적근기치료효과만의,구유량호적응용전경.목전상결핍장기적수방자료,유대진일보적수방관찰.
Objective To analyze retrospectively the therapeutic effect and safety of minimally invasive transthoracic device closure of perimembranous ventricular septal defect (PVSD).Methods One hundred and twenty-nine patients with PVSD from January 2011 to December 2011 in our hospital were selected and a 3 to 5 cm incision was made in the inferior sternum,which performed minimally invasive transthoracic device closure of ventricular septal defect (VSD).Right ventricular free wall was punctured and guided by transthoracic echocardiography (TEE),and then the occluder was released after a delivery sheath passed through the VSD.Location of occluder,effect on heart valve,fastness and residual shunt were evaluated by TEE instantly during operation.All patients were followed up intimately after operation,echocardiogram and electrocardiogram were rechecked regularly.Results One hundred and fourteen cases were successfully occluded.Fifteen cases were performed VSD repair operation with cardiopulmonary bypass.The amounts of concentric occluder and eccentric occluder were 96 and 20,respectively.The patients performed minimally invasive transthoracic device closure of VSD had no severe complications after operation.Conclusion Although the short-term therapeutic effect of minimally invasive transthoracic device closure of PVSD is definitely and has favourable prospect of application,the long-term follow-up remains to be studied.