经胸微创封堵术治疗继发孔房间隔缺损140例分析

发布时间：2018-02-27 02:19

本文关键词： 经胸小切口继发孔房间隔缺损封堵器经食管超声心动图　出处：《中国医学科学院学报》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨经胸小切口继发孔房间隔缺损(ASD)微创封堵术的可行性及有效性。方法回顾性分析2004年8月至2014年7月收治的140例继发孔房间隔缺损患者,其中男47例、女93例,年龄3~63岁,房间隔缺损直径6~36 mm。患者均于静吸复合全麻下,经右前胸第4肋间小切口进胸,在术中经食管超声(TEE)引导下行房缺封堵术。结果 134例患者经封堵器封堵成功。6例患者因封堵不成功,改行体外循环下ASD修补术。封堵失败原因包括:术后封堵伞脱落2例,均为中央型大ASD,以及术中封堵不成功4例,其中术中TEE发现残余分流2例、筛孔状ASD 1例、术中封堵器脱落1例。术后规律随访,随访期间无严重并发症发生。结论 TEE引导下经胸小切口非体外循环下ASD封堵术安全、有效、创伤小、操作简便,有一定推广价值。
[Abstract]:Objective to investigate the feasibility and effectiveness of transthoracic small incision ASD minimally invasive closure of atrial septal defect (ASD). Methods from August 2004 to July 2014, 140 patients with ASD were retrospectively analyzed, including 47 males and 93 females. Aged 3 to 63 years, the diameter of atrial septal defect (ASD) was 66 mm. All the patients were treated by the fourth intercostal small incision in the right anterior chest under general anesthesia. Results ASD repair under cardiopulmonary bypass (CPB) was performed in 6 patients who were successfully occluded by transesophageal transcatheter closure device. The reasons for the failure include: 2 cases of loss of occluding umbrella after operation, 6 cases of successful occlusion by transesophageal transesophageal transcatheter closure device (TEE), and 6 cases of successful occlusion under cardiopulmonary bypass (CPB). All of them were central ASD, and 4 cases were not successfully occluded during operation. Among them, 2 cases were found residual shunt during TEE, 1 case was sieve hole ASD, 1 case was lost of occluder during operation, and followed up regularly after operation. No serious complications occurred during the follow-up period. Conclusion the transthoracic small incision ASD closure under the guidance of TEE is safe, effective, minimally invasive and easy to operate, and is worth popularizing.
【作者单位】：中日友好医院心脏血管外科;新疆维吾尔自治区人民医院心外科;
【分类号】：R654.2

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