Transcatheter closure of a ruptured sinus of Valsalva aneurysm
Transcatheter closure of a ruptured sinus of Valsalva aneurysm
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DOI：
10.1253/circj.70.1043
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发表时间：
2006-08-01
影响因子：
3.3
通讯作者：
Wang, Jou-Kou
中科院分区：
文献类型：
--
作者：
Chang, Chi-Wei;Chin, Shuenn-Nan;Wang, Jou-Kou
背景 Valsalva 窦瘤破裂 (RSVA) 可能与室间隔缺损或孤立性病变有关。手术修复一直是 RSVA 的传统治疗方法。报道了4例RSVA患者经导管封堵的结果。 方法和结果2003年至2004年，确定了4例RSVA患者（2男2女），年龄从18岁到47岁。 RSVA 的诊断是基于多种影像学检查的结合。 RSVA 的引流部位为右心室（2 例）和右心房（其余 2 例）。所有患者在手术过程中均接受全身麻醉和经食管超声心动图（TEE）监测。所有 4 名患者均尝试使用 Amplatzer 导管封堵器进行经导管封堵。所选 Amplatzer 导管封堵器的尺寸比 TEE 图像上测量的 RSVA 主动脉开口部位的最大直径大 2 毫米。 3 例尝试部署 Amplatzer 导管封堵器成功，1 例部署 Gianturco 弹簧圈。随访（3-18 个月）超声心动图显示所有患者均未出现残余分流或主动脉瓣反流。 结论 经导管技术是治疗 RSVA 的安全替代方案；然而，更长时间的随访是强制性的。
Background Ruptured sinus of Valsalva aneurysms (RSVA) can be associated with ventricular septal defects or isolated lesions. Surgical repair has been the traditional treatment of for the RSVA. The results of transcatheter closure of the RSVA in 4 patients are reported.Methods and Results From 2003 to 2004, 4 patients (2 males and 2 females) aged from 18 years to 47 years with RSVA were identified. The diagnosis of RSVA was made based on a combination of several imaging modalities. The drainage site of the RSVA was right ventricle in 2, and right atrium in remaining 2. All patients underwent general anesthesia and transesophageal echocardiographic (TEE) monitoring during the procedure. Transcatheter closure with an Amplatzer duct occluder was attempted in all 4 patients. The size of the Amplatzer duct occluder selected was up to 2 mm larger than the maximal diameter of the aortic opening site of the RSVA as measured on TEE images. The attempt to deploy an Amplatzer duct occluder was successful in 3 and a Gianturco coil was deployed in 1. Follow-up (3-18 months) echocardiography showed neither residual shunt nor aortic regurgitation in any of the patients.Conclusion The transcatheter technique is a safe alternative in the treatment of RSVA; however, a longer follow-up is mandatory.