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目的探讨Amplatzer室间隔封堵器(AVSO)介入治疗膜周部室间隔缺损(PMVSD)的临床疗效。方法应用AVSO介入治疗72例PMVSD病人。结果手术技术成功率93.1%(67/72例)。PMVSD大小(4.7±2.1)mm,PMVSD距主动脉瓣(2.1±1.0)mm,AVSO大小(7.1±2.6)mm。即刻封闭率94.0%。心律失常发生率20.8%(15/72例),新发生的轻度三尖瓣关闭不全1例,加重的主动脉瓣关闭不全及少-中等残余分流1例。平均随访(10.7±6.6)个月,轻度主动脉瓣关闭不全1例,室性加速性心动过速1例,无残余分流、封堵器移位、破损及感染性心内膜炎发生。结论应用AVSO介入治疗PMVSD疗效好、安全性高,但要高度重视其可能发生的并发症,尤其是要做好心律失常的防治。
Objective To investigate the clinical effect of Amplatzer septal occluder (AVSO) interventional therapy on perimembranous ventricular septal defect (PMVSD). Methods 72 cases of PMVSD were treated with AVSO interventional therapy. Results The success rate of surgical technique was 93.1% (67/72 cases). The size of PMVSD was (4.7 ± 2.1) mm, the PMVSD was 2.1 ± 1.0 mm from aortic valve, and the AVSO size was (7.1 ± 2.6) mm. Immediate closure rate of 94.0%. The incidence of arrhythmia was 20.8% (15/72 cases), new cases of mild tricuspid regurgitation (1 case), exacerbated aortic regurgitation and minimal-moderate residual shunt in 1 case. The mean follow-up (10.7 ± 6.6) months, mild aortic insufficiency in 1 case, ventricular tachycardia in 1 case, no residual shunt, occluder displacement, damage and infective endocarditis occurred. Conclusions The application of AVSO interventional therapy for PMVSD is effective and safe. However, it is important to pay attention to its possible complications, especially for the prevention and treatment of arrhythmia.