[Percutaneous transcatheter closure for secundum atrial septal defect].

Xiang-qian Shen, Sheng-hua Zhou, Mei Gao
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Abstract

Objective: To evaluate the effect of transcatheter closure treatment for secundum atrial septal defect(ASD).

Methods: ASD was established by transthoracic echocardiogram (TTE) and transvenous cardiac catheterization. A balloon catheter was inserted at ASD and was inflated to measure the ASD stretched diameter. Then, a long sheath was inserted to the left atrium (LA) from the right atrium( RA), Thereafter a proper auto-expanded atrial septal occluder (ASO) was inserted to the tip of the sheath. Under the fluoroscopic and TTE guidance, the ASO was expanded. Once the position of ASO was optimal, it was released.

Results: From May 1999 to July 2002, 32 patients were treated with this method. Among them, 28 patients (87.5%) obtained satisfactory results. At the end of the operation, TTE could not find out any residual shunt. Before discharging the patients, TTE showed the diameter of the right atrium and the right ventricle were decreased from (39.4 +/- 5.8) mm to (33.7 +/- 4.2) mm and from (45.3 +/- 6.8) mm to (37.1 +/- 4.5) mm respectively (P < 0.001 for both). The operation failed in 4 patients (12.5%). Two patients did not get proper ASO for them in the early period of our work. ASO slipped off from the defects in another 2 patients during the operation. There were no other complications.

Conclusion: Tanscatheter closure is suitable for most patients with ASD. It is safe and less invasive with few complications.

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[经皮经导管闭合术治疗房间隔缺损]。
目的:探讨经导管闭锁治疗继发性房间隔缺损(ASD)的效果。方法:采用经胸超声心动图(TTE)和经静脉心导管诊断ASD。在ASD处插入球囊导管,充气后测量ASD拉伸直径。然后,从右心房(RA)插入一个长鞘到左心房(LA),然后在鞘的尖端插入一个适当的自动扩张房间隔封堵器(ASO)。在透视和TTE引导下,扩大ASO。一旦ASO位置达到最佳,就将其释放。结果:1999年5月至2002年7月,采用该方法治疗32例患者。其中28例(87.5%)获得满意效果。在手术结束时,TTE没有发现任何残留的分流器。出院前,TTE显示右心房和右心室直径分别从(39.4 +/- 5.8)mm减小到(33.7 +/- 4.2)mm,从(45.3 +/- 6.8)mm减小到(37.1 +/- 4.5)mm (P < 0.001)。手术失败4例(12.5%)。2例患者在我们工作的早期没有得到合适的ASO。另外2例患者术中ASO从缺损处脱落。没有其他并发症。结论:大多数ASD患者适合导管闭合。它安全,侵入性小,并发症少。
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[Effects of nitric oxide on form-deprivation myopia in chicks]. [Percutaneous transcatheter closure for secundum atrial septal defect]. [Serum levels of antibodies for IgG, IgA, and IgM against the fungi antigen in psoriasis vulgaris]. [Etiologic analysis of 1137 inpatients of chronic renal failure]. [Clinical analysis of intrahepatic cholestasis during pregnancy in 150 patients].
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