Transcatheter closure of large atrial septal defects with deficient aortic or posterior rims using the "Greek maneuver". A multicenter study.
Transcatheter closure of large atrial septal defects with deficient aortic or posterior rims using the "Greek maneuver". A multicenter study.
复制标题
使用“希腊操作”经导管封闭主动脉或后缘缺陷的大房间隔缺损。
DOI：
10.1016/j.ijcard.2013.05.011
复制
发表时间：
2013
影响因子：
3.5
通讯作者：
E. Karanasios
中科院分区：
文献类型：
--
作者：
B. Thanopoulos;Petros Dardas;V. Ninios;Nicholaos G. Eleftherakis;E. Karanasios
目的我们报告一项修改使用Amplatzer间隔封堵器（ASO）的标准房间隔缺损（ASD）闭合技术的希腊操作（"Greek maneuver"），以促进主动脉瓣或后缘缺陷的大型ASD的闭合。（中位数10.8，范围3 - 52岁）（平均直径26 ± 7 mm，范围20 - 40 mm），主动脉瓣缺损（134例患者）或后缘（51例患者），在经食管引导下使用"希腊操作"使用AMPLATZER间隔封堵器进行导管闭合。当超声心动图检测到器械展开的左盘的主动脉边缘突出到右心房时，应用希腊动作。为了绕过该左盘，重新捕获该左盘，并且将整个递送系统向内推动并重新进入左心房，在左心房中同时释放左盘和右盘的2/3。这个动作迫使左磁盘成为平行的隔膜，防止该设备的突起到右atrium.ResultsThe ASO成功植入，并与175/185（95%）的患者完全关闭。有没有早期或晚期并发症的程序在随访期间，从6个月至7 years. ConclusionsThe "希腊机动"是一个简单的非常有用的技巧，有利于关闭大ASD相关或没有缺陷的主动脉或后边缘。
ObjectivesWe report a modification (“Greek maneuver”) of the standard atrial septal defect (ASD) closure technique using the Amplatzer septal occluder (ASO) to facilitate closure of large ASDs with deficient aortic or posterior rims.Methods185 patients (median 10.8, range 3 to 52 years) with large ASDs (mean diameter 26 ± 7 mm, range 20–40 mm) with a deficient aortic (134 patients) or posterior (51 patients) rim underwent catheter closure with the ASO using the “Greek maneuver” under transesophageal guidance. The Greek maneuver is applied when protrusion of the aortic edge of the deployed left disk of the device in to the right atrium is detected by echo. To circumvent this left disk is recaptured and the whole delivery system is pushed inward and leftward into the left atrium where the left disk and the 2/3 of right disk are simultaneously released. This maneuver forces the left disk to become parallel to the septum preventing the protrusion of the device into the right atrium.ResultsThe ASO was successfully implanted and was associated with complete closure in 175/185 (95%) of the patients. There were no early or late complications related to the procedure during a follow-up period ranging from 6 months to 7 years.ConclusionsThe “Greek maneuver” is a simple quite useful trick that facilitates closure of large ASDs associated with or without deficient aortic or posterior rims.