Percutaneous transcatheter closure of atrial septal defect guided by transesophageal echocardiography in adult patients
10.3760/cma.j.cn112434-20190927-00337
- VernacularTitle:单纯超声心动图引导经皮房间隔缺损封堵术在成人心外科中的应用研究
- Author:
Shuyang LU
1
;
Lili DONG
;
Wangchao YAO
;
Kai SONG
;
Tao HONG
;
Hao LAI
;
Yongxin SUN
;
Chunsheng WANG
Author Information
1. 复旦大学附属中山医院心外科 上海市心血管病研究所
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2020;36(10):617-620
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness and safety of transcatheter closure of atrial septum defect(ASD) in adults using echocardiography as the only imaging tool.Methods:From April 2017 to August 2019, 118 patients with congenital atrial septum defect were treated by cardiac surgery in Zhongshan Hospital affiliated to Fudan University. There were 31 males and 87 females, aged 15-72 years old[mean(40.3±15.3) years old]. 117 cases of atrial septum defect were secondary foramen and 1 case was residual shunt after repair of atrial septum defect by transthoracic echocardiography. The patients with tricuspid insufficiency and pulmonary hypertension were followed up by transesophageal echocardiography.Results:The transcatheter closure of atrial septum defect(ASD) was successfully performed in 114 patients. 3 patients were successfully treated with right fourth intercostal small incision atrial defect occlusion due to the coaxial problem of occlusive device and atrial defect. One patient underwent repair of atrial septum defect during the correction of right ventricular injury. The selected size of occluder ranged from 12 mm to 38 mm. One case of ethmoidal orifice was successfully blocked with double occlusive device. There was no occlusive device displacement, no obvious residual shunt, peripheral vascular injury and other complications occurred in successful occlusive patients. 110 patients were directly transferred back to the general ward after extubation. The postoperative hospital stay was(2.3±1.1) days and the total hospitalization time was(4.5±1.7) days. There were 7 patients with tricuspid regurgitation above mild to moderate before operation, and 6 patients with tricuspid regurgitation decreased to mild regurgitation after occlusion. One month after operation, the pulmonary artery pressure of 51 patients with moderate and severe pulmonary hypertension decreased from(50.4±11.4)mmHg to(38.9±12.9) mmHg( P<0.05). The occlusive device was well fixed and no residual shunt was found. Conclusion:Transesophageal echocardiography guided transcatheter closure of atrial septum defect is not only safe and effective in adult cardiac surgery, but also can avoid radiation and contrast agent injury.
