Clinical Feasibility of Percutaneous Closure for Subarterial Ventricular Septal Defect Using Asymmetric Occluder Device_West China Medical Journal

Authors：

QIU Xu ¹ ,  FENG Yuan ² , GAN Changping ¹ , AN Qi ¹ , SHI Yingkang. ¹

1. Department of Cardiovascular Surgery; 2. Department of Cardiology; West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

FENG Yuan, Email: qiuxu613@foxmail.com

Keywords：

干下型室間隔缺損; 主動脈瓣脫垂; 導管介入; 封堵器; 微創治療

DOI：

10.7507/1002-0179.20130267

Video：

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目的　觀察和評價采用偏心型封堵器導管介入治療干下型室間隔缺損的近期療效和安全性。方法　2011年8月－12月，6例經無主動脈瓣脫垂的干下型室間隔缺損（直徑≤7 mm）患者（年齡＞3歲）在雜交手術室接受介入治療。造影評估后，建立動靜脈軌道，在保留導絲的情況下置入合適型號的國產偏心型室間隔缺損封堵器，并于術后定期隨訪復查。結果　6例患者缺損直徑4～7 mm（平均5.3 mm），其中5例成功地接受了導管介入封堵治療，置入封堵器直徑5～9 mm（平均6.4 mm）。僅1例因封堵器置入后出現主動脈瓣受壓影響關閉，即改由外科微創經胸封堵成功。所有患者在隨訪期內，無栓塞、殘余分流、瓣膜功能障礙、房室傳導阻滯、死亡等并發癥。結論　無主動脈瓣脫垂的干下型室間隔缺損患者接受導管介入封堵治療是安全、可行的，且短期隨訪結果良好。

Citation： QIU Xu,FENG Yuan,GAN Changping,AN Qi,SHI Yingkang.. Clinical Feasibility of Percutaneous Closure for Subarterial Ventricular Septal Defect Using Asymmetric Occluder Device. West China Medical Journal, 2013, 28(6): 848-851. doi: 10.7507/1002-0179.20130267 Copy

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14.	Zhou T, Shen XQ, Zhou SH, et al. Atrioventricular block: a serious complication in and after transcatheter closure of perimembranous ventricular septal defects[J]. Clinical Cardiology, 2008, 31(8): 368-371.
15.	Yip WC, Zimmerman F, Hijazi ZM. Heart block and empirical therapy after transcatheter closure of perimembranous ventricular septal defect[J]. Catheter Cardiovasc Interv, 2005, 66(3): 436-441.

1. 　Rudolph AM. Congenital Diseases of the heart: clinical-physiological considerations[M]. 3rd ed. West Sussex: John Wiley & Sons Ltd, 2009: 148-178.
2. 　Anderson RH, Wilcox BR. The surgical anatomy of ventricular septal defects[J]. J Card Surg, 1992, 7(1): 17-35.
3. 　Tweddell JS, Pelech AN, Frommelt PC. Ventricular septal defect and aortic valve regurgitation: pathophysiology and indications for surgery[J]. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu, 2006, 9(1): 147-152.
4. 　de Leval MR, Pozzi M, Starnes V, et al. Surgical management of doubly committed subarterial ventricular septal defects[J]. Circulation, 1988, 78 (5 Pt 2): Ⅲ 40-46.
5. 　Kirklin WJ, Barrat-Boys BG. Cardiac Surgery[M]. 2nd ed. New York: Churchill Livingston, 1993: 749-824.
6. 　Gan C, An Q, Lin K, et al. Perventricular device closure of ventricular septal defects: six months results in 30 young children[J]. Ann Thorac Surg, 2008, 86(1): 142-146.
7. 　Lock JE, Block PC, McKay RG, et al. Transcatheter closure of ventricular septal defects[J]. Circulation, 1988, 78(2): 361-368.
8. 　Szkutnik M, Qureshi SA, Kusa J, et al. Use of the amplatzer muscular ventricular septal defect occluder for closure of perimembranous ventricular septal defects[J]. Heart, 2007, 93(3): 355-358.
9. 　Lê TP, Vaessen P, Freudenthal F, et al. Transcatheter closure of subaortic ventricular septal defect (VSD) using a nickel-titanium spiral coil (NitOcclud): animal study and initial clinical results[J]. Prog Ped Cardio, 2001, 14(1): 83-88.
10. 　Sim EKW, Grignani RT, Wong ML, et al. Outcome of surgical closure of doubly committed subarterial ventricular septal defect[J]. Ann Thorac Surg, 1999, 67(3): 736-738.
11. 　Moodie DS. Technology insight: transcatheter closure of ventricular septal defects[J]. Nat Clin Pract Cardiovasc Med, 2005, 2(11): 592-596.
12. 　Gu M, You X, Zhao X, et al. Transcatheter device closure of intracristal ventricular septal defects[J]. Am J Cardiol, 2011, 107(1): 110-113.
13. 　Fu YC, Bass J, Amin Z, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S. phase I trial[J]. JACC, 2006, 47(2): 319-325.
14. 　Zhou T, Shen XQ, Zhou SH, et al. Atrioventricular block: a serious complication in and after transcatheter closure of perimembranous ventricular septal defects[J]. Clinical Cardiology, 2008, 31(8): 368-371.
15. 　Yip WC, Zimmerman F, Hijazi ZM. Heart block and empirical therapy after transcatheter closure of perimembranous ventricular septal defect[J]. Catheter Cardiovasc Interv, 2005, 66(3): 436-441.

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Clinical Feasibility of Percutaneous Closure for Subarterial Ventricular Septal Defect Using Asymmetric Occluder Device

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