先天性心脏病复合畸形患者行同期介入治疗的长期疗效及安全性观察

龙向淑; 杨太; 张长海; 谭洪文; 张萍; 刘晓桥

doi:10.13201/j.issn.1001-1439.2019.12.018

先天性心脏病复合畸形患者行同期介入治疗的长期疗效及安全性观察

- 1 贵州省人民医院心内科(贵阳, 550002);
- 2 贵州大学医学院;
- 3 毕节市第一人民医院心内科
基金项目:
贵州省科技合作计划项目(No:黔科合LH字【2015】7160号)

贵阳市科技计划项目(No:筑科合同【20151001】社53号)

详细信息

通讯作者: 张萍,E-mail:xin7110p@163.com

中图分类号: R541.1

收稿日期: 2019-04-16

Long-term efficacy and security of concurrent interventional therapy for patients with congenital heart disease complex malformation

- 1 Department of Cardiology, Guizhou Province People's Hospital, Guiyang, 550002, China;
- 2 Medical College, Guizhou University;
- 31 Department of Cardiology, The First People's Hospital of Bijie City

More Information

Corresponding author: ZHANG Ping, E-mail: xin7110p@163.com

Received Date: 16 April 2019

摘要

摘要: 目的:探讨先天性心脏病复合畸形(CHDCM)患者行同期介入治疗的长期疗效及安全性。方法:纳入CHDCM患者28例,均行2种或2种以上不同组合的同期介入治疗,评估术前及术后6个月的血流动力学参数、肺动脉收缩压(sPAP)、左室射血分数(LVEF)、心腔大小以及至术后12个月的并发症等。结果:28例CHDCM患者同期介入治疗均成功;与术前比较,术后sPAP下降,LVEF升高,右室舒张末期内径(RVD)、右房面积(RAA)及心/胸比均减小(均P<0.05);8例合并肺动脉瓣狭窄(PS)亚组患者的术后右心室压(RVP)及跨肺动脉瓣压差均较术前下降(均P<0.05)。28例患者术后均无死亡或封堵器脱落。1例房间隔缺损(ASD)合并动脉导管未闭(PDA)患儿术后出现重度血小板减少,1例ASD合并室间隔缺损(VSD)患者术后出现间歇性完全性左束支传导阻滞,予治疗后3 d均恢复正常。1例VSD合并ASD患者心室水平见少量左向右分流,1例ASD合并VSD患者术后出现中度三尖瓣关闭不全,2例ASD合并VSD患者术后出现主动脉瓣轻度关闭不全,以上4例患者随访至术后12个月,上述情况未加重。结论:在严格掌握介入适应证及介入策略实施正确的前提下,同期介入治疗CHDCM有效可行,长期观察预后良好。
- 同期介入治疗 /
- 先天性心脏病复合畸形 /
- 长期预后
Abstract: Objective:To investigate the long-term efficacy and security of patients with congenital heart disease complex malformation(CHDCM) treated with concurrent interventional.Method:Twenty-eight patients with CHDCM underwent two or more different combined concurrent interventional therapies were enrolled.Preoperative and postoperative hemodynamic parameters,pulmonary artery systolic pressure(sPAP),left ventricular ejection fraction(LVEF),cardiac chamber size,complications up to 12 months after therapy,etc.were collected and evaluated.Result:Twenty-eight patients were successfully treated with concurrent interventional therapy. After operation,sPAP decreased,LVEF increased,and right ventricular end diastolic diameter(RVD),right atrium area(RAA),and heart/thorax ratio were decreased(all P<0.05).The postoperative right ventricular pressure(RVP) and transpulmonary valve pressure difference were lower than those before operation in 8 patients with PS(all P<0.05).There was no death or occlusion device falling off in 28 patients.One patient with ASD complicated with PDA had severe thrombocytopenia after operation,and 1 patient with ASD complicated with VSD had intermittent complete left bundle branch block after operation,both of them returned to normal after treatment.One patients with VSD complicated with ASD had a small amount of left to right shunt,1 patient with ASD complicated with VSD had moderate tricuspid insufficiency after operation,2 patients with ASD complicated with VSD had mild aortic valve insufficiency after operation,all of them were followed up until 12 months after therapy,and the above situation was not aggravated.Conclusion:Under the premise of strict control of interventional indications and correct implementation of intervention strategies,concurrent interventional therapy for CHDCM is effective and feasible,and the long-term prognosis is good.
- concurrent interventional therapy /
- congenital heart disease complex malformation /
- long-term prognosis

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