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目的:评价房间隔瘤(ASA)并发继发孔型房间隔缺损(ASD)介入封堵术的可行性、安全性和疗效。方法:16例(男4例,女12例),年龄12～66(30.6±14.1)岁。经临床、心电图、X线及经胸超声心动图(TTE)检查诊断为ASA并发继发孔型ASD。TTE检查ASA均膨入右心房,ASD最大直径10～32(17.1±10.4)mm。其中单孔ASD14例,双孔ASD2例,孔间距离均小于7mm。结果:16例均一次封堵成功,成功率100%。所用封堵器的直径为16～42(28.5±6.99)mm。2例双孔ASD中,置入1个封堵器直接封堵2个缺损孔。术中TTE监测检查示15例完全闭合,1例有少量残余分流。术后3d复查TTE示均无残余分流;6个月、1年后复查示9例心脏大小恢复正常,均无残余分流,无封堵器移位及其他并发症。结论:介入封堵治疗ASA并发继发孔型ASD是可行、安全的,可获得良好的封堵效果。
Objective: To evaluate the feasibility, safety and efficacy of atrial septal defect (ASA) complicated with secundum atrial septal defect (ASD). Methods: 16 cases (4 males and 12 females) aged 12-66 years (30.6 ± 14.1 years). The clinical, electrocardiogram, X-ray and transthoracic echocardiography (TTE) diagnosis of ASA complicated secondary perforation ASD. TTE ASA were swollen into the right atrium, ASD maximum diameter of 10 ~ 32 (17.1 ± 10.4) mm. Including 14 cases of single-hole ASD, two cases of double-hole ASD, the distance between the holes are less than 7mm. Results: All the 16 cases were successfully occluded, with a success rate of 100%. The occluder used is 16 to 42 (28.5 ± 6.99) mm in diameter. In 2 cases of double-hole ASD, 1 occluder was inserted to block 2 defect holes directly. Intraoperative TTE monitoring showed complete closure of 15 cases, 1 case of a small residual shunt. No recurrence of residual shunt was observed after 3 days of TTE examination. At 6 months and 1 year after the operation, 9 cases recovered to normal heart size with no residual shunt and no occluder displacement and other complications. Conclusion: It is practicable and safe to block ASA complicated secondary perforation ASD with blocking therapy.