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大型Amplatzer间隔封堵器脱落后介入取出及房间隔缺损再封堵成功一例
患者男性,32岁.因胸闷、气短半个月入院.胸骨左缘第2肋间闻及3/6级收缩期杂音.超声心动图示右心房、右心室(47 mm)扩大,房间隔中部连续中断32 mm,左心室缩小(37 mm),三尖瓣中度反流,肺动脉收缩压51 mm Hg(1 mm Hg=0.133 kPa).
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Objective To evaluate the safety and efficacy of the Amplatzer septal occluder for transcatheter closure in patients with secundum atrial septal defect (ASD Ⅱ).Methods Patients with clinically confirmed ASD Ⅱ were recommended for transcatheter closure of ASD Ⅱ. Results 30 ASD Ⅱ patients (20 females) underwent transcatheter closure at a median age of 18.4 years (5-55 years). Both the stretched diameters of ASDs and the sizes of the devices were from 18 to 34?mm (25±7?mm). The successful placement rate was 100%. The rest shunt documented by color Doppler, was immediately after implantation in 40% of patients, in 9.9% after 24 hours, and in 3.3% trace at 3 months. No serious complications were observed. There was improvement in symptoms and in cardiac size. Septal motion abnormalities normalized in all patients after 3 months follow-up.Conclusion The Amplatzer septal occluder is a safe and effective device for transcatheter closure of ASD Ⅱ. Long-term follow-up is still required before widespread clinical use can be recommended.