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：

干下型室间隔缺损; 主动脉瓣脱垂; 导管介入; 封堵器; 微创治疗

DOI：

10.7507/1002-0179.20130267

Video：

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目的　观察和评价采用偏心型封堵器导管介入治疗干下型室间隔缺损的近期疗效和安全性。方法　2011年8月－12月，6例经无主动脉瓣脱垂的干下型室间隔缺损（直径≤7 mm）患者（年龄＞3岁）在杂交手术室接受介入治疗。造影评估后，建立动静脉轨道，在保留导丝的情况下置入合适型号的国产偏心型室间隔缺损封堵器，并于术后定期随访复查。结果　6例患者缺损直径4～7 mm（平均5.3 mm），其中5例成功地接受了导管介入封堵治疗，置入封堵器直径5～9 mm（平均6.4 mm）。仅1例因封堵器置入后出现主动脉瓣受压影响关闭，即改由外科微创经胸封堵成功。所有患者在随访期内，无栓塞、残余分流、瓣膜功能障碍、房室传导阻滞、死亡等并发症。结论　无主动脉瓣脱垂的干下型室间隔缺损患者接受导管介入封堵治疗是安全、可行的，且短期随访结果良好。

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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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.

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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