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上海市卫生健康委员会
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经皮导管介入治疗主动脉窦瘤破裂的疗效和安全性研究
To evaluate the safety and effectiveness of the Transcatheter occlusion of the ruptured sinus of aortic aneurysm

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DOI:
作者:
管丽华 谢迪杨 周达新1 陈丹丹 张蕾 潘文志 葛均波
Guan Lihua, Xie Diyang, Zhou Daxin1 , Chen Danda
作者单位:
复旦大学附属中山医院
Department of Cardiology, Zhongshan Hospital, Fudan University Shanghai Institute of Cardiovascular Disceases 180 Fenglin Road, Shanghai 200032, China
关键词:
主动脉窦瘤破裂 动脉导管未闭、室间隔缺损封堵器 介入治疗
Ruptured sinus of aortic aneurysm, PDA and VSD occluder , Interventional treatment
摘要:
目的 评价经皮导管介入治疗主动脉窦瘤破裂的疗效和安全性以及中短期随访。方法 共12例主动脉窦瘤破裂患者，男性8例，女性4例，年龄16-64岁（38.9+13.2），使用动脉导管未闭（PDA）封堵器或室间隔缺损（VSD）封堵器，经皮导管介入封堵的方法治疗，通过6个月的随访，评价其疗效和安全性。结果 主动脉造影显示主动脉窦破口最窄径为9.9±2.9mm（7-15mm），11例患者成功封堵，有效率为：91.7%，其中9例运用腰部直径大于破口最窄2-4mm的PDA封堵器封堵，2例运用腰部直径大于破口最窄径3-5mm的VSD封堵器封堵。患者均成功封堵，心超随访均未见残余分流，未合并或合并轻度主动脉瓣反流，无血栓栓塞、感染性心内膜炎、心肌缺血等并发症发生。与同一时期通过外科手术修补者，住院天数及医疗费用显著下降。结论 经皮介入封堵治疗主动脉窦瘤破裂安全、有效、经济。
To evaluate the safety and effectiveness of the Transcatheter occlusion of the ruptured sinus of aortic aneurysm Guan Lihua Xie Diyang Zhou Daxin1 Chen Dandan Zhang Lei Pan Wenzhi Ge Junbo Department of Cardiology, Zhongshan Hospital, Fudan University Shanghai Institute of Cardiovascular Disceases 180 Fenglin Road, Shanghai 200032, China Abstract: Aims: To evaluate the immediate and mid-term outcome of transcatheter closure using PDA or VSD occluder in patients with ruptured sinus of aorta( RSA). Methods: Twelve patients (8 males and 4 females) aged from 16 to 64 years who suffered from RSA were enrolled this study.. The exclusion criteria are accompanied severe aortic regurgitation, complex congenital heart diseases in need of surgical correction, infective endocarditis and so on. Two dimentional and color Doppler echocardiography revealed right coronary sinus(RCS) ruptured into right atrium(RA) in 2 patients and into right ventricular(RV) in 8 patients including 3 with very small ventricular septal defect(VSD), whereas non-coronary sinus ruptured(NCS) into RA in another 2 patients. All these patients were followed-up 6 months, to evaluate the safety and effectiveness of the transcatheter closure using PDA occluder or VSD occluder made in China. Both the lenth of stay and hospitalization costs of these patients were less than those who receive surgery during the same period. Results : The defects were 7-15mm at its narrowest end measured by angiography. 11 patients were successfully occluded, the effectiveness is 91.7%. 9 patients were successfully occluded using Chinese-made PDA occluder 2-4mm larger than the narrowest end and 2 were successfully occluded useing Chinese-made VSD occluder 3-5mm larger than the narrowest end. Echocardiography immediately post-procedure or during follow-ups showed neither residual nor severe aortic regurgitation. There was no device embolism, infective endocarditis or hemolysis in any of the patients. In contrast with surgery, the hospitalization of patients treated by TCC and the recovery time was shorter. Conclusion: Transcatheter closure using PDA occluder or VSD occluder is feasible and effective with encouraging short and mid-term outcomes. Key Word: Ruptured sinus of aortic aneurysm, PDA and VSD occluder , Interventional treatment

 

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