先天性心脏病介入封堵治疗前后左心室内径改变的对比

目的研究经导管先天性心脏病介入封堵术前后左心室内径改变的对比。方法通过经胸超声心动图（TTE）选择适合封堵的先天性心脏病患者636例，其中动脉导管未闭（PDA）228例，房间隔缺损（ASD）168例，室间隔缺损（VSD）240例。在TTE及x射线引导下行介入封堵术，术后通过胸片和TTE进行动态的随访观察。结果605例患者封堵成功，手术成功率为95．1％，31例封堵未成功，改为体外循环下手术矫正畸肜。术后100％的患者接受了1—2个月随访，85％的患者接受了12个月以上随访。x射线检查全部显示肺血减少；TTE检查PDA及VSD患者封堵术后1—2月左心室腔缩小（P〈0．01），ASD封堵术后左心室内径无明显改变（r=0．45，P〉0．05）；心电图提示无明显心律失常发生。结论经导管先天性心脏病封堵术后1—2个月，PDA及VSD患者左心室明显减小。

Contrastive study on changes of left ventricle before and after transcatheter closure in treating congenital heart disease

Objective To study the changes of left ventricle before and after transcatheter clo- sure in treating congenital heart disease. Methods 636 patients with congenital heart disease were selected by transthoracic echocardiography （TTE）, among whom 228 with patent ductus arteriosus （PDA）, 168 with atrial septal defect （ASD）, 240 with ventricular septal defect （VSD）. Transcatheter closure was performed under the guidance of TTE and X-ray. The patients were followed up with electrocardiogram, chest X-ray and TTE after the operation. Results The operation was successful for 605 patients and the success rate was 95.1%. 31 unsuccessful cases were rectified under cardiopulmonary bypass. 100% of the cases were followed up for 1~2 months after the closure, and 85% of the cases were followed up for 12 months after the closure. X-ray demonstrated the load of lung was ~educing. TTE demonstrated the size of left ventricle with PDA or VSD was decreased after 1-2 months of closure （P 〈0.01）; the change of the size of left ventricle with ASD was not obvious （r=0.45, P 〈0.01）. electrocardiogram demonstrated no obvious arrhythmogenesis. Conclusion The decrease of left ventricle with PDA or VSD is obvious.