CAJ | 학술논문

目的：探讨经胸微创封堵治疗先天性心脏病术后近期心脏几何构型的变化。方法先天性心脏病患者31例，其中单纯性室间隔缺损（VSD）10例和房间隔缺损（ASD）21例，观察患者封堵术前、术后3个月左室内径（LVD）、左房内径（LAD）、右房内径（RAD）和右室内径（RVD）大小及左室射血分数（LVEF）变化。结果31例患者中封堵成功29例（93．5％），其中单纯性VSD患者10例，单纯性ASD患者19例；失败2例（6．5％）均为单纯性ASD患者。封堵术后3个月，10例VSD患者LAD和LVD较术前明显缩小（P＜0．05），RVD及LVEF明显增加（P＜0．05）；19例ASD患者RAD及RVD较术前明显减小（P＜0．05），LVD及LVEF明显增加（P＜0．05）。结论经胸微创封堵治疗ASD和VSD能有效地改善先天性心脏病患者近期心脏重构。
목적：탐토경흉미창봉도치료선천성심장병술후근기심장궤하구형적변화。방법선천성심장병환자31례，기중단순성실간격결손（VSD）10례화방간격결손（ASD）21례，관찰환자봉도술전、술후3개월좌실내경（LVD）、좌방내경（LAD）、우방내경（RAD）화우실내경（RVD）대소급좌실사혈분수（LVEF）변화。결과31례환자중봉도성공29례（93．5％），기중단순성VSD환자10례，단순성ASD환자19례；실패2례（6．5％）균위단순성ASD환자。봉도술후3개월，10례VSD환자LAD화LVD교술전명현축소（P＜0．05），RVD급LVEF명현증가（P＜0．05）；19례ASD환자RAD급RVD교술전명현감소（P＜0．05），LVD급LVEF명현증가（P＜0．05）。결론경흉미창봉도치료ASD화VSD능유효지개선선천성심장병환자근기심장중구。
Objective To explore the short-term changes of cardiac geometric morphology after minimally invasive transthoracic closure of congenital heart disease.Methods Thirty-one patients with congenital heart disease were enrolled in this study,including 10 cases of ventricular septal defect (VSD) and 21 cases of atrial septal defect(ASD).Left ventricular diameter(LVD),left atrial diameter (LAD),right atrial diameter(RAD),right ventricular diameter(RVD) and left ventricular ejection fraction(LVEF) were measured before and three months after the closure.Results Of 31 cases,the closure was successfully completed in 29 cases(93.5%) including 10 cases of VSD and 19 cases of ASD,but was failed in 2 cases of ASD(6.5%).Three months after the closure,for the 10 patients with VSD,LAD and LVD decreased significantly,while RVD and LVEF increased significantly compared with those before the closure(both P<0.05). For the 19 patients with ASD,RAD and RVD decreased significantly,while LVD and LVEF increased significantly compared with those before the closure(both P<0.05).Conclusion Minimally invasive transthoracic closure can effectively improve the short-term cardiac remodeling of patients with congenital heart disease.