目的 观察主动脉窦瘤破入右房经导管介入封堵治疗的临床疗效和随访效果.方法 对7例主动脉窦瘤破入右房患者进行介入封堵治疗,观察介入封堵术即刻及术后1、7d的超声心动图、心电图、血尿常规、肝肾功等变化,并于30、90、180d随访观察超声心动图、心电图等的变化.结果 超声测量7例患者窦瘤破裂入口径和出口径分别为9.286±1.604ram和5.914±1.708mm,升主动脉造影测量窦瘤破裂入口径和出口径分别为10.286±1.496mm和6.500±1.384mm.患者均采用腰径为12.000±1.623mm的封堵器.术后无溶血、主动脉瓣反流增加等并发症;术后7、30、90、180d超声心动图显示舒张末期左室内径均较术前明显改善,封堵器对瘤壁及冠脉开口、主动脉瓣无明显影响.结论 经皮介入封堵治疗主动脉窦瘤破入右房是一种微创、安全、有效的治疗方法.%Objective To investigate the clinical effect and follow-up results of transcatheter occlusion in sinus of Valsalva aneurysm (RSVA) ruptured into right atrium. Methods Seven patients, including six with the rupture of right coronary sinus of Valsalva and one with the rupture of the noncoronary sinus of Valsalva shunting into the right atrium, were involved in present study and had been undergone transcatheter interventional occlusion. Echocardiography, electrocardiography, blood and urine routine tests, and liver and kidney function tests were performed instantly and at day 1 and day 7 after operation. All patients were evaluated by echocardiography, electrocardiography, X-rays at 30, 90 and 180 days of follow-up. Results The RSVA size of seven patients ranged from 5. 914±1.078mm to 9. 286 ± 1. 604mm examined by echocardiography, and 6. 5 ± 1. 384mm to 10. 286 ± 1.496mm by assending aorta angiography. All patients were accepted persisting arterial duct (PDA) occluder with diameter of 12. 000 ± 1.623mm. Five patients gained successful transcatheter closure without residual shunt, and no hemolysis and aortic regurgitation occurred postoperatively. Left ventricular diameter decreased significantly at 7, 30, 90 and 180 day after operation than that before operation. The occluder had no influence on aneurysm wall, outlet of coronary artery and aortic valve. Conclusion Transcatheter closure with PDA occluder is a safe and effective therapy for RSVA with micro-trauma.
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