Percutaneous Perventricular Device Closure of Ventricular Septal Defect: From Incision to Pinhole
Percutaneous Perventricular Device Closure of Ventricular Septal Defect: From Incision to Pinhole
复制标题
经皮经室装置封堵室间隔缺损：从切口到针孔
DOI：
10.1016/j.athoracsur.2016.09.061
复制
发表时间：
2017-01-01
影响因子：
4.6
通讯作者：
Lin, Ke
中科院分区：
文献类型：
--
作者：
Gan, Changping;Peng, Ling;Lin, Ke
背景作为开放手术修复的替代方法，经心室封堵器为双动脉下室间隔缺损提供了微创治疗。然而，与经皮经导管入路不同，仍然需要小切口开胸术。本报告描述了经皮经心室装置关闭技术及其对这种类型的心脏缺陷的短期结果。16例孤立性双动脉下室间隔缺损患者接受了经皮经心室器械闭合术。通过在经食管超声心动图的连续引导下穿刺胸壁，随后穿刺右心室漏斗部，将导丝和输送鞘管推进到心脏中，以完成经心室闭合。在医院和1年随访期间测量闭合结局和可能的并发症。结果15例患者（93.8%）成功闭合。围手术期或整个随访期间均未发生死亡、残余分流、新发瓣膜返流或心律失常。1例患者出现心包积液和心包填塞，手术转为小切口经心室闭合术。平均住院时间为3.5 +/- 2.0天（范围：3.0 - 6.0天），仅1例患者需要输血（6.3%）。孤立性双动脉下型室间隔缺损的经皮经心室器械封堵术似乎是安全有效的，短期结局可接受。需要进行更大规模的研究和长期随访以进一步评估。(C)2017胸外科医师协会
Background. As an alternative to open surgical repair, perventricular device closure provides minimally invasive treatment for doubly committed subarterial ventricular septal defects. However, unlike percutaneous transcatheter access, mini-thoracotomy is still needed. This report describes the percutaneous perventricular device closure technique and its short-term results for this type of heart defect.Methods. Sixteen patients who had isolated doubly committed subarterial ventricular septal defects underwent percutaneous perventricular device closure. By puncture of the chest wall and subsequently the infundibulum of the right ventricle under continuous guidance of transesophageal echocardiography, the guidewire and the delivery sheath were advanced into the heart to complete the perventricular closure. Closure outcomes and possible complications were measured in the hospital and during 1-year follow-up. Results. Closure was successful in 15 patients (93.8%). No deaths, residual shunting, new valve regurgitation, or arrhythmias occurred either perioperatively or during the entire follow-up period. One patient had pericardial effusion and tamponade, and the procedure was converted to mini-thoracotomy perventricular closure. The mean hospital stay was 3.5 +/- 2.0 days (range, 3.0 to 6.0 days), and only 1 patient required a blood transfusion (6.3%).Conclusions. Percutaneous perventricular device closure of isolated doubly committed subarterial ventricular septal defects appeared to be safe and efficacious, with acceptable short-term outcomes. Larger studies and long-term follow-up are needed for further evaluation. (C) 2017 by The Society of Thoracic Surgeons