Clinical Application of Minimally Invasive Transthoracic Occlusion in Ventricular Septal Defect_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

李伟 ,  顾伟礼 , 励峰 , 王晓舟

上海交通大学附属胸科医院心外科（上海 200030）;

Corresponding author：

顾伟礼, Email: gwl281@163.com

Keywords：

室间隔缺损; 封堵术; 微创; 经食管超声心动图

DOI：

10.7507/1007-4848.20160042

Video：

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目的探讨临床应用微创经胸小切口封堵术治疗室间隔缺损（ventricular septal defect，VSD）的初步经验方法回顾性分析我院心外科2006年4月至2013年12月施行微创经胸小切口封堵术治疗205例VSD患者的临床资料。其中，男112例、女93例，年龄4个月～62（10.2± 12.5）岁，无合并其它心内畸形，术前经胸超声心动图筛查，术中经食管超声心动图监测、引导，胸骨下段小切口或左胸第3肋间胸骨旁小切口行VSD封堵术。术后密切随访病情，定期随访心电图、胸部X线片（后前位+左侧位）、超声心动图。结果全组患者无死亡。封堵成功200例（97.6%），封堵失败转行体外循环下手术修补5例，术后并发VSD残余漏3例，无新发主动脉瓣及三尖瓣反流、封堵伞脱落、二次开胸、完全性房室传导阻滞、溶血等并发症。结论微创经胸小切口VSD封堵术安全、有效，技术日臻成熟，临床应用值得推广，但仍需注意团队医师间配合以及指征把握。

Citation： 李伟, 顾伟礼, 励峰, 王晓舟. Clinical Application of Minimally Invasive Transthoracic Occlusion in Ventricular Septal Defect. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(2): 191-193. doi: 10.7507/1007-4848.20160042 Copy

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2.	闰玉生, 肖飞.经胸微创伤房间隔缺损封堵术.实用医学杂志, 2005, 21(10): 1007-1008.
3.	肖燕燕, 金梅, 韩玲, 等.先天性心脏病介入治疗发展史及新进展.心肺血管病杂志, 2012, 31(6): 755-758.
4.	杨新超, 柳德斌, 王炜.经胸小切口封堵术与外科手术治疗膜部室间隔缺损的对比研究.中国心血管病研究, 2014, 12(4): 323-326.
5.	唐红, 张尔永, 解俊敏, 等.食管超声心动图监测下经胸微创房间隔缺损封堵术.中国胸心血管外科临床杂志, 2006, 13(5): 349-351.
6.	Li F, Chen M, Qiu ZK, et al. A new minimally invasive technique to occlude ventricular septal defect using all occluder device. Ann Thorac Surg, 2008, 85(3): 1067-1071.
7.	Tao K, Lin K, Shi Y, et al. Perventricular device closure of perimem-branous ventricular septal defects in 61 young children:early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4): 864-870.
8.	Michel-Behnke I, Ewert P, Koch A, et al. Device closure of ventri-cular septal defects by hybrid procedures:a multicenter retrospec-tive study. Catheter Cardiovasc Interv, 2011, 77(2): 242-251.
9.	马兰, 吴卫华, 陆静, 等.经食管超声心动图在经胸小切口室间隔缺损封堵术中的应用.中国临床医学, 2011, 18(6): 852-854.
10.	Gu M, You X, Zhao X, et al. Transcatheter device closure of intracristal ventricular septal defects. Am J Cardiol, 2011, 107(1): 110-113.
11.	徐建新, 蒋国平, 康曼丽, 等.多普勒组织速度成像法在评价室间隔缺损左心功能中的作用.实用儿科临床杂志, 2004, 19(3): 195-197.
12.	李红昕, 梁飞, 郭文彬, 等.经右胸-右心房途径微创室间隔缺损封堵术.中华胸心血管外科杂志, 2012, 28(12): 712-715.

1. 徐志伟, 主编.小儿心脏手术学.第2版.北京:人民军医出版社, 2006: 337-350.
2. 闰玉生, 肖飞.经胸微创伤房间隔缺损封堵术.实用医学杂志, 2005, 21(10): 1007-1008.
3. 肖燕燕, 金梅, 韩玲, 等.先天性心脏病介入治疗发展史及新进展.心肺血管病杂志, 2012, 31(6): 755-758.
4. 杨新超, 柳德斌, 王炜.经胸小切口封堵术与外科手术治疗膜部室间隔缺损的对比研究.中国心血管病研究, 2014, 12(4): 323-326.
5. 唐红, 张尔永, 解俊敏, 等.食管超声心动图监测下经胸微创房间隔缺损封堵术.中国胸心血管外科临床杂志, 2006, 13(5): 349-351.
6. Li F, Chen M, Qiu ZK, et al. A new minimally invasive technique to occlude ventricular septal defect using all occluder device. Ann Thorac Surg, 2008, 85(3): 1067-1071.
7. Tao K, Lin K, Shi Y, et al. Perventricular device closure of perimem-branous ventricular septal defects in 61 young children:early and midterm follow-up results. J Thorac Cardiovasc Surg, 2010, 140(4): 864-870.
8. Michel-Behnke I, Ewert P, Koch A, et al. Device closure of ventri-cular septal defects by hybrid procedures:a multicenter retrospec-tive study. Catheter Cardiovasc Interv, 2011, 77(2): 242-251.
9. 马兰, 吴卫华, 陆静, 等.经食管超声心动图在经胸小切口室间隔缺损封堵术中的应用.中国临床医学, 2011, 18(6): 852-854.
10. Gu M, You X, Zhao X, et al. Transcatheter device closure of intracristal ventricular septal defects. Am J Cardiol, 2011, 107(1): 110-113.
11. 徐建新, 蒋国平, 康曼丽, 等.多普勒组织速度成像法在评价室间隔缺损左心功能中的作用.实用儿科临床杂志, 2004, 19(3): 195-197.
12. 李红昕, 梁飞, 郭文彬, 等.经右胸-右心房途径微创室间隔缺损封堵术.中华胸心血管外科杂志, 2012, 28(12): 712-715.

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