首页|Amplatzer动脉导管封堵器-Ⅱ治疗伴发主动脉窦脱垂室间隔缺损患儿效果分析

Amplatzer动脉导管封堵器-Ⅱ治疗伴发主动脉窦脱垂室间隔缺损患儿效果分析

Clinical efficacy of Amplatzer duct occluder-Ⅱ device for the treatment of ventricular septal defect with aortic sinus prolapse in child patients

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目的 探讨Amplatzer动脉导管封堵器(ADO)-Ⅱ治疗伴发主动脉窦脱垂室间隔缺损(VSD)患儿的效果.方法 回顾性收集 2018 年 1 月至 2022 年 9 月于湖南省儿童医院住院治疗的 94 例伴发主动脉窦脱垂VSD患儿临床资料.其中男 60 例,女 34 例,年龄为(4.7±3.1)岁;主动脉窦轻中度脱垂 83例,VSD为(4.12±0.97)mm,重度脱垂 11 例,VSD为(4.95±0.51)mm;VSD类型为膜周部 54 例,嵴内以上 40例.分析VSD大小、主动脉窦脱垂程度与ADO-Ⅱ选择的关系,以及术后中期主动脉瓣反流、残余漏变化,明确ADO-Ⅱ对此类患儿的适用性.结果 术后中期最终存留主动脉瓣轻度反流 6 例,多发于使用 4-4 mm、5-4mm型ADO-Ⅱ封堵器;残余漏 10 例,主要发生于使用 5-4 mm、6-4 mm型封堵器.结论 ADO-Ⅱ封堵器在置入形态良好状况下,适用于VSD<6 mm伴主动脉窦脱垂患儿.术后有一定的残余漏和主动脉脉瓣反流发生,但能满足介入治疗要求.
Objective To investigate the efficacy of Amplatzer duct occluder-Ⅱ device(ADO-Ⅱ)in treating ventricular septal detect(VSD)with aortic sinus prolapse(ASP)in child patients.Methods The clinical data of 94 child patients with VSD complicated by ASP,who were admitted to the Hunan Provincial Children's Hospital of China between January 2018 and September 2022,were retrospectively collected.The child patients included 60 males and 34 females with a mean age of(4.7±3.1)years.Mild-moderate ASP was seen in 83 child patients,with a mean(4.12±0.97)mm-sized VSD.Severe ASP was seen in 11 child patients,with a mean(4.95±0.51)mm-sized VSD.Perimembrane VSD was observed in 54 child patients and intracristal VSD in 40 child patients.The relationship of VSD size and degree of ASP to the selection of ADO-Ⅱ,postoperative middle period aortic valve regurgitation and residual leakage was analyzed,so as to clarify the applicability of ADO-Ⅱ to such child patients.Results In the postoperative middle period,6 child patients had mild aortic valve regurgitation,most seen in the child patients who received 4-4 mm or 5-4 mm ADO-occluder;and 10 child patients had residual leakage,mainly seen in the child patients who received 5-4 mm or 6-4 mm occluder.Conclusion In the condition when the ADO-Ⅱ occluder shows satisfactory placement pattern,this treatment is suitable for the child patient having<6 mm VSD with ASP.Although there are some residual leakage and aortic valve regurgitation after surgery,this interventional therapy still meets the clinical requirements.(J Intervent Radiol,2024,32:17-21)

ventricular septal detectaortic sinus prolapseAmplatzer duct occluder-Ⅱ

左超、陈智、肖云彬、杨舟、王祥、王野峰、向金星

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410007 湖南长沙 湖南省儿童医院心血管内科

室间隔缺损 主动脉窦脱垂 Amplatzer动脉导管封堵器-Ⅱ

湖南省卫生健康委科研计划项目湖南省儿童心血管病临床医学研究中心项目

2022060137692021SK4019

2024

介入放射学杂志
上海市医学会

介入放射学杂志

CSTPCD北大核心
影响因子:1.866
ISSN:1008-794X
年,卷(期):2024.33(1)
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