Closure of Atrial Septal Defect by Video-assisted Thoracoscopic Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

胡云南 ,  曹華 , 陳強 , 張貴燦

福建醫科大學附屬協和醫院心臟外科（福州 350001）;

Corresponding?author：

曹華, Email: caohua69@hotmail.com

Keywords：

房間隔缺損; 外科封堵技術; 胸腔鏡; 臨床研究

DOI：

10.7507/1007-4848.20150244

Video：

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目的探討全胸腔鏡輔助房間隔缺損封堵術治療房間隔缺損的可行性及體會。方法 2012年1月至2013年12月福建醫科大學附屬協和醫院心外科收治房間隔缺損患者28例，其中男10例、女18例，年齡15～45（30.5±12.9）歲。采取全胸腔鏡輔助，使用特殊的輸送鞘管，將封堵傘嵌入房間隔缺損處將其封閉，反復推拉封堵傘無移位，超聲檢查提示房水平無殘余分流、對周圍各重要結構無影響后釋放封堵器，術后分別采用心臟彩色超聲心動圖、心電圖及胸部X線片評價治療效果。結果 28例封堵成功。手術時間58～100 min，心內封堵操作時間5～10 min，住ICU 2 h至1 d，住院時間3～7 d。3例患者出現圍手術期心律失常，包括室上性心動過速、心房撲動，經藥物處理后短時間內恢復正常；1例術后少量胸腔積液未予特殊處理。隨訪3～12個月，無封堵傘移位、無殘余分流及血栓等相關并發癥發生。結論全胸腔鏡輔助房間隔缺損封堵術是安全有效的，易于臨床推廣。

Citation： 胡云南, 曹華, 陳強, 張貴燦. Closure of Atrial Septal Defect by Video-assisted Thoracoscopic Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(10): 984-986. doi: 10.7507/1007-4848.20150244 Copy

1.	Kirklin JW,Barratt-Boyes BG.Atrial septal defect and partial anomalous pulmonary venous connection.Cardiac surgery,1993,2(1):609-644.
2.	Yew G,Wilson NJ.Transcatheter atrial septal defect closure with the Amplatzer septal occluder:five-year follow-up.Catheter Cardiovasc Interv,2005,64(2):193-196.
3.	Zanchetta M,Rigatelli G,Pedon L.Transcatheter atrial septal defect closure assisted by intracardiac echocardiography:3-year follow-up.J Interv Cardiol,2004,17(2):95-98.
4.	Formigari R,Di Donato RM,Mazzera E,et al.Minimally invasive or interventional repair of atrial septal defects in children:experience in 171 cases and comparison with conventional strategies.J Am Coll Cardiol,2001,37(6):1707-1712.
5.	Li GS,Kong GM,Wang YL,et al.Safety and efficacy of transcatheter closure of atrial septal defects guided by transthoracic echocardography:a prospective study from two Chinese Medical Centers.Ultrasound Med Biol,2009,35(1):58-64.
6.	張海洲,李楊,劉維,等.經胸小切口房間隔缺損封堵術.山東醫藥,2007,47(36):49-50.
7.	楊侃,韓冬,張壯,等.經胸微創外科封堵房間隔缺損的臨床研究.醫藥論壇雜志,2007,28(21):54-55.
8.	Chen Q,Chen LW,Cao H,et al.Intraoperative device closure of atrial septal defect in infants.Ann Thorac Surg,2010,89(4):1250-1254.
9.	Chen Q,Chen LW,Cao H,et al.Intraoperative device closure of atrial septal defects with inferior vena cava rim deficiency:a safe alternative to surgical repair.J Thorac Cardiovasc Surg,2011,141(3):631-636.
10.	Chen Q,Cao H,Zhang GC,et al.Safety and feasibility of intraoperative device closure of atrial septal defect with transthoracic minimal invasion.Eur J Cardiothorac Surg.2012,41(1):121-125.
11.	Yu SQ,Cai ZJ,Cheng YG,et al.Video-assisted thoracoscopic surgery for congenital heart disease.Asian Cardiovasc Thorac Ann,2002,10(3):228-230.
12.	Chang CH,Lin PJ,Chu JJ,et al.Video-assisted cardiac surgery in closure of atrial septal defect.Ann Thorac Surg,1996,62(3):697-701.
13.	Burke RP,Wernovsky G,van der Velde M,et al.Video-assisted thoracoscopic surgery for congenital heart disease.J Thorac Cardiovasc Surg,1995,109(3):499-507.
14.	Lavoie J,Burrows FA,Hansen DD.Video-assisted thoracoscopic surgery for the treatment of congenital cardiac defects in the pediatric population.Anesth Analg,1996,82(3):563-567.
15.	張貴燦,陳良萬,邱罕凡,等.微創外科房間隔缺損封堵術的超聲心動圖評價.福建醫科大學學報,2008,42(5):433-435.
16.	張貴燦,主編.現代超聲心動圖學.福州:福建科學技術出版社,2009.282-290.
17.	Li GS,Kong GM,Ji QS,et al.Reliability of transthoracic echocardiography in estimating the size of Amplatzer septal occluder and guiding percutaneous closure of atrial septal defects.Chin Med J,2008,121(11):973-976.

1. Kirklin JW,Barratt-Boyes BG.Atrial septal defect and partial anomalous pulmonary venous connection.Cardiac surgery,1993,2(1):609-644.
2. Yew G,Wilson NJ.Transcatheter atrial septal defect closure with the Amplatzer septal occluder:five-year follow-up.Catheter Cardiovasc Interv,2005,64(2):193-196.
3. Zanchetta M,Rigatelli G,Pedon L.Transcatheter atrial septal defect closure assisted by intracardiac echocardiography:3-year follow-up.J Interv Cardiol,2004,17(2):95-98.
4. Formigari R,Di Donato RM,Mazzera E,et al.Minimally invasive or interventional repair of atrial septal defects in children:experience in 171 cases and comparison with conventional strategies.J Am Coll Cardiol,2001,37(6):1707-1712.
5. Li GS,Kong GM,Wang YL,et al.Safety and efficacy of transcatheter closure of atrial septal defects guided by transthoracic echocardography:a prospective study from two Chinese Medical Centers.Ultrasound Med Biol,2009,35(1):58-64.
6. 張海洲,李楊,劉維,等.經胸小切口房間隔缺損封堵術.山東醫藥,2007,47(36):49-50.
7. 楊侃,韓冬,張壯,等.經胸微創外科封堵房間隔缺損的臨床研究.醫藥論壇雜志,2007,28(21):54-55.
8. Chen Q,Chen LW,Cao H,et al.Intraoperative device closure of atrial septal defect in infants.Ann Thorac Surg,2010,89(4):1250-1254.
9. Chen Q,Chen LW,Cao H,et al.Intraoperative device closure of atrial septal defects with inferior vena cava rim deficiency:a safe alternative to surgical repair.J Thorac Cardiovasc Surg,2011,141(3):631-636.
10. Chen Q,Cao H,Zhang GC,et al.Safety and feasibility of intraoperative device closure of atrial septal defect with transthoracic minimal invasion.Eur J Cardiothorac Surg.2012,41(1):121-125.
11. Yu SQ,Cai ZJ,Cheng YG,et al.Video-assisted thoracoscopic surgery for congenital heart disease.Asian Cardiovasc Thorac Ann,2002,10(3):228-230.
12. Chang CH,Lin PJ,Chu JJ,et al.Video-assisted cardiac surgery in closure of atrial septal defect.Ann Thorac Surg,1996,62(3):697-701.
13. Burke RP,Wernovsky G,van der Velde M,et al.Video-assisted thoracoscopic surgery for congenital heart disease.J Thorac Cardiovasc Surg,1995,109(3):499-507.
14. Lavoie J,Burrows FA,Hansen DD.Video-assisted thoracoscopic surgery for the treatment of congenital cardiac defects in the pediatric population.Anesth Analg,1996,82(3):563-567.
15. 張貴燦,陳良萬,邱罕凡,等.微創外科房間隔缺損封堵術的超聲心動圖評價.福建醫科大學學報,2008,42(5):433-435.
16. 張貴燦,主編.現代超聲心動圖學.福州:福建科學技術出版社,2009.282-290.
17. Li GS,Kong GM,Ji QS,et al.Reliability of transthoracic echocardiography in estimating the size of Amplatzer septal occluder and guiding percutaneous closure of atrial septal defects.Chin Med J,2008,121(11):973-976.

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