Objective To evaluate long-term efficacy and safety of intervention treatment for aged patients with secundum atrial septal defect(ASD). Methods A total of 206 aged patients with secundum ASD undergoing transcatheter closure successfully were studied. The diameter of ASD was 26.5±8. 1 mm(ranging from 8 to 38 mm). Echocardiography, the pulmonary arterial and right ventricular pressure were detected by catheter before and after the procedure immediately.Results The transcatheter closure was successfully done in 203(98.5％) of the 206 patients. The diameter of the occluder selected was 31. 5 ± 7.3 mm(ranging 12 to 42). The pulmonary artery systolic pressure after the procedure was decreased (P ＜ 0.05). The mean right ventricular systolic pressure after the procedure was also decreased (P ＜ 0.05). The right atrial and ventricular size and LVEF examined by the echocardiography were improved and no residual shunt,embolic disease and shift of occluder were found at 6 months follow-up. Conclusion Intervention closure can be used effectively and safely for treatment of secundum ASD in aged patients.%目的 观察老年继发孔型房间隔缺损(ASD)患者进行介入封堵术的中、远期疗效和安全性.方法 老年继发孔型ASD患者206例,缺损8～38(26.5±8.1)mm.封堵术前、术后行右心导管检测肺动脉压、右心室压,随访6个月,评价心功能(NYHA)改善情况.结果 成功封堵203例,成功率98.5%.封堵器直径12～42(31.5±7.3)mm.与封堵术前比较,患者封堵术后肺动脉收缩压、右心室平均压明显下降(P＜0.05,P＜0.01);3～6个月随访时,患者右心室客积缩小、LVEF升高、心功能改善明显.术后心包积液1例(0.5%);即刻残余分流10例(4.9%);术后出现心律失常30例(14.8%)、出现急性心功能不全16例(7.9%).6个月随访,患者均未发现有残余分流、脱落、栓塞.结论 老年继发孔型ASD患者行介入封堵治疗中、远期相对安全、有效.
展开▼
