超声引导下经右颈内静脉可调弯鞘行房间隔缺损封堵术的临床应用

杨超; 廖胜杰; 方剑; 马伦超; 陆国梁; 张英元; 黄杰周; 谢少波

doi:10.13201/j.issn.1001-1439.2016.12.007

超声引导下经右颈内静脉可调弯鞘行房间隔缺损封堵术的临床应用

- 1 广州医科大学附属第一医院心脏外科(广东, 510120);
- 2 广州医科大学附属第一医院麻醉科

详细信息

通讯作者: 谢少波,E-mail:tjxhyc@126.com

中图分类号: R541.1

收稿日期: 2016-03-29

修回日期: 2016-07-24

Percutaneous trans-jugular vein closure of atrial septal defect with steerable introducer under echocardiographic guidance

- 1 Department of Cardiothoracic Surgery;
- 2 Department of Anesthesiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China

More Information

Corresponding author: XIE Shaobo, E-mail: tjxhyc@126.com

Received Date: 29 March 2016

Revised Date: 24 July 2016

摘要

摘要: 目的:探讨一种全新的超声引导下经右颈内静脉可调弯鞘的房间隔缺损(ASD)封堵手术方式。方法:共15例ASD患者经颈内静脉穿刺,送入可调弯鞘,超声引导下调节鞘管头端,使其与房间隔平面垂直并居于ASD正中,选择适当大小的封堵器通过鞘管,常规释放左盘伞及右盘伞。结果:所有患者均封堵成功,手术时间(27.4±5.6)min,心内操作时间(6.7±5.2)min,全部病例无残余分流,住院期间无死亡,无心律失常、溶血及心内感染,无颈内静脉损伤及栓塞。术后随访1个月,所有患者无残余分流,无封堵器脱落、移位等并发症。结论:超声引导下经右颈内静脉可调弯鞘ASD封堵术是一种操作简单,创伤轻微,适应证更广,并发症更小的新术式,较传统的经皮介入封堵、经胸封堵有明显优势。
- 超声引导 /
- 颈内静脉 /
- 房间隔缺损
Abstract: Objective: To discuss a novel surgical approach of percutaneous trans-jugular vein closure of atrial septal defect (ASD) with steerable introducer under echocardiographic guidance.Method: Fifteen ASD patients underwent percutaneous trans-jugular vein ASD closure, the occluder was placed in direction perpendicular to the plane of ASD using the steerable introducer.Result: All cases succeeded. The average procedure time was (27.4±5.6)minutes; and the average intracardiac operation time was (6.7±5.2)minutes. No patient showed residual shunt after the procedure. There was no clinical death, no arrhythmia, no hemolysis, no infection, no jugular vein damage or occlusion during patients' hospitalization. The post-operation follow up after one month of the operation showed that there was no residual shunt, no falling off or detachment of occluders or other complications.Conclusion: It is a new surgical method with easy operation, mild damage and wider indication. Compared with the traditional percutaneous and transthoracic closure of ASD, it has obvious advantages.
- echocardiographic guidance /
- jugular vein /
- atrial septal defect

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