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目的评估经导管封堵室间隔缺损(VSD)的临床疗效与安全性。方法先行左室造影了解VSD的形态、位置及大小,建立跨VSD的动静脉导丝轨道,并沿轨道导丝经静脉放入传送鞘管及封堵器,经心脏超声检测及左室、主动脉造影证实封堵器位置合适后将其释放。术后定期随访,复查心脏超声及心电图。结果181例VSD患者中175例封堵治疗获得成功,成功率96.7%。封堵成功者中有162例完成了(15.4±9.23)个月(1个月~3年)的随访,1例于术后10h发生溶血反应,经治疗3d后恢复正常;2例分别于术后第4天及第6天发生间歇性完全性房室传导阻滞,经大剂量氢化可的松等治疗后恢复;无严重并发症发生。结论经导管封堵VSD是一项安全、有效的治疗手段,可使VSD患者得到根治。
Objective To evaluate the clinical efficacy and safety of transcatheter closure of ventricular septal defect (VSD). Methods The left ventricular angiography was performed to understand the shape, location and size of the VSD. The guidewire was placed across the VSD. The guidewire was placed along the guidewire through the vein to deliver the sheath and occluder. The cardiac ultrasound and left ventricular Arteriography confirmed that the occluder was released in the right position. Regular follow-up after surgery, review of echocardiography and ultrasound. Results Among 181 patients with VSD, 175 cases were successfully treated with blockade, with a success rate of 96.7%. One hundred and two cases of follow-up were (15.4 ± 9.23) months (1 month to 3 years), and 1 case had hemolysis reaction 10 hours after operation, and returned to normal after 3 days of treatment. Two cases Intermittent complete atrioventricular block occurred on the fourth day and the sixth day after the treatment, and was recovered after treatment with high-dose hydrocortisone. No serious complications occurred. Conclusion Transcatheter closure of VSD is a safe and effective treatment, which can cure patients with VSD.