[1]李勇,张秀辉,张玉春.经胸小切口封堵治疗3岁以下小儿室间隔缺损[J].中国微创外科杂志,2011,11(5):424-430.
　Li Yong,Zhang Xiuhui,Zhang Yuchun..Miniincision Transthoracic Occlusion of VSD in Children Under 3 Years[J].Chinese Journal of Minimally Invasive Surgery,2011,11(5):424-430.
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经胸小切口封堵治疗3岁以下小儿室间隔缺损()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
11
期数:
2011年5期
页码:
424-430
栏目:
出版日期:
2011-05-20

文章信息/Info

Title:
Miniincision Transthoracic Occlusion of VSD in Children Under 3 Years
作者:
李勇; 张秀辉; 张玉春
山东省临沂市人民医院心外科，临沂276003
Author(s):
Li Yong;  Zhang Xiuhui;  Zhang Yuchun.
Department of Cardiovascular Surgery, Linyi People’s Hospital, Linyi 276003, China
关键词:
经胸小切口; 封堵器; 室间隔缺损
Keywords:
Transthoracic miniincision; Occluder; Ventricular septal defect
分类号:
R726.1
文献标志码:
A
摘要:
目的评价经胸小切口封堵治疗3岁以下小儿室间隔缺损的临床疗效和安全性。方法2007年3月～2010年3月，选择49例3岁以下患儿，食道超声引导下经胸小切口封堵室间隔缺损。胸骨下段3～5 cm切口暴露右心室，将输送装置刺入右心室，在超声引导下经过室间隔缺损，释放室间隔缺损封堵器(上海记忆合金公司)，食道超声评估封堵器的位置、对三尖瓣和主动脉瓣的影响以及有无残余分流。结果3例转体外循环手术。46例封堵成功，安置封堵器时间10～60 min，（25.1±9.2）min，住院时间4～7 d，（5.2±0.7）d。随访6～36个月，平均17个月，无残余分流，无心律失常，无主动脉瓣和三尖瓣反流。1例迟发型心脏压塞，经心包引流后治愈。结论经胸小切口封堵术易于操作，疗效确切，安全可靠。
Abstract:
ObjectiveTo evaluate the efficacy and safety of miniincision transthoracic occlusion of VSD in children aged less than 3 years old. MethodsWe performed 49 cases of miniincision transthoracic occlusion for VSD in children < 3 years, under the guidance of transesophageal echocardiography, from March 2007 to March 2010. A 3 to 5cm incision was made in the lower sternum to expose the right ventricle outlet, at which 2 pursestring sutures were placed. And a catheter was introduced into the right ventricle through the purse, and passed through the defect into the left ventricle under the guidance of transesophageal echocardiography. An occluder was then released to engage on the defect, and the catheter was withdrawn. After the procedure, we evaluated the position of the occluder and its influence on tricuspid and aortic valves, as well as residual shunt. ResultsIn the patients, 46 cases received the occlusion successfully and other 3 were converted to cardiopulmonary bypass. The mean time for the occlusion was 10 to 60 min with a mean of (25.1±9.2) min. The patients were discharged from hospital in 4 to 7 days with a mean of (5.2±0.7) days. A mean of 17 months followup was achieved in the patients (6 to 36 months), during which no residual shunts, arrhythmia, or tricuspid regurgitation was observed. ConclusionMiniincision transthoracic occlusion of VSD is safe, reliable and easy to handle.

参考文献/References:

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更新日期/Last Update: 2013-04-18