[1]易定华,俞世强,徐学增,等.经胸小切口封堵房间隔缺损手术效果观察[J].中国微创外科杂志,2006,06(2):113-114.
　Yi Dinghua,Yu Shiqiang,Xu Xuezeng,et al.Experience on transthoracic occlusion of atrial septal defect[J].Chinese Journal of Minimally Invasive Surgery,2006,06(2):113-114.
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经胸小切口封堵房间隔缺损手术效果观察()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年2期
页码:
113-114
栏目:
出版日期:
2006-02-20

文章信息/Info

Title:
Experience on transthoracic occlusion of atrial septal defect
作者:
易定华; 俞世强; 徐学增; 魏旭峰
第四军医大学西京医院心血管外科,西安,710032
Author(s):
Yi Dinghua;  Yu Shiqiang;  Xu Xuezeng;  et al
Department of Cardiovascular Surgery, Xijing Hospital of Fourth Military Medical University, Xi'an 710032, China
关键词:
经胸小切口; 房间隔缺损; 封堵器
Keywords:
Transthoracic mini-incision; 　Atrial septal defect; 　Occluder
分类号:
R654.2
文献标志码:
A
摘要:
目的总结经胸小切口封堵房间隔缺损手术经验与疗效.方法2001年5月～2005年9月,我院采用非体外循环经胸小切口治疗房间隔缺损206例,房间隔缺损直径4.8～44.3 mm,其中＞30 mm 100例,房间隔缺损伴膨出瘤2例.右侧第4肋间做2～3 em小切口,显露右心房并在其外侧壁荷包缝合,将双腔推送导管穿刺入右心房,在食管超声引导下经房间隔缺损送入左心房,并释放直径比房间隔缺损最大径大4 mm的镍钛记忆合金封堵器,退出推送导管.结果206例均顺完成手术.手术时间18～32(26±7)min.无手术死亡,无封堵器脱落.术后5 h拔除气管插管,患者当日即可下床活动.术后3 d复查彩色多普勒,无残余分流.术后住院(4±2)d.186例随访6个月,57例随访3～4.5年,病人恢复良好,彩色多普勒显示均无残余分流,心功能均正常.结论经胸小切口封堵方法治疗房间隔缺损安全可靠,适用于不能介入封堵的房间隔缺损治疗.
Abstract:
Objective　To summarize the experience and efficacy ofmini-incision transthoracic occlusion ofatrial septaldefect (ASD).　M ethods　Off-pump mini-incision transthoracic occlusion of atrial septal defectwas conducted in 206 from May 2001 to September2005 in this hospita.l The defect diameter ranged 4. 8 ~44. 3 mm and was >30 mm in 100 patients. The ASD was associated with atrial septal aneurysm in 2 patients. An incision 2~3 cm in length wasmade in the 4th intercostal space of the right parasternum to expose the right atrium, at which a purse-string suture was placed. A double-lumen delivery catheter was then punctured into the right atrium, and passed through the defect to the left atrium under the guidance of transesophageal echocardiography. An occludermade of a nickel-titanium metal alloy and 4 mm bigger than the defectwas released to engage on the defect. The delivery catheterwas thenwithdrawn.　Results　The operationwas successfully accomplished in all the 206 patients. The operation time was 18 ~32 min(mean, 26±7 min). No surgery-related death happened and no occluder dislodgment occurred. Mechanical ventilation was stopped at5 hours after operation, and all the patients gotoutofbed on the operation day. ColourDoppler imaging 3 days after operation showed complete occlusion of the ASD without residual shunt. The length of hospitalization was 4±2 days. Follow-up examinations for 6 months in 186 patients and for 3~4. 5 years in 57 patients by using Colour Doppler imaging revealed no residual shuntand normal cardiac functions.　Conclusions　Mini-incision transthoracic occlusion ofatrial septaldefect is safe and reliable in patients contraindicated to transcatheter closure.

参考文献/References:

[1]Thomson JD,Aburawi EH,Watterson KG,et al.Surgical and transcatheter (Amplatzer) closure of atrial septal defects:a prospective comparison of results and costs.Heart,2002,87:466-469.
[2]俞世强,蔡振杰,康云帆,等.胸部小切口非体外循环治疗先天性心脏病房问隔缺损中国微创外科杂志,2002,2:292-294.
[3]Formigari R,Santoro G,Rossetti L,et al.Comparison of three different atrial septal defect occlusion devices.Am J Cardiol,1998,82:690-692.
[4]Berger F,Ewert P,Bjornstad PG,et al.Transcatheter closure as standard treatment for moat interatrial defects:experience in 200patients treated with the Amplatzer Septal Occluder.Cardiol Young,1999,9:468-473.

更新日期/Last Update: 2014-01-27