中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

新型导丝系统在超声引导房间隔缺损封堵术中的应用价值

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目的 评估新型导丝系统在单纯超声引导经皮房间隔缺损封堵术中的安全性和有效性。 方法 将 20 只实验羊随机分为两组,即试验组和对照组,每组 10 只。两组均采用经胸球囊扩张法建立房间隔缺损动物模型,在单纯超声引导下行房间隔缺损经皮封堵操作。试验组采用新型导丝系统,对照组采用传统导丝系统。比较两组操作时间、导丝通过房缺时间、导丝脱出房间隔缺损次数、术中心律失常发生次数以及并发症的发生情况。 结果 两组动物均顺利建立房间隔缺损模型,成功植入房间隔缺损封堵器。试验组和对照组比较,平均操作时间(15.36±4.86)min vs.(25.82±7.85)min;平均通过缺损时间(2.69±0.82)min vs.(5.58±3.34)min;导丝脱入右房频率(0% vs. 40%);房性早搏(4.41±2.61 vs. 9.60±3.68)或室性早搏发生频率(0.75±0.36 vs. 1.34±0.68)均低于对照组,差异有统计学意义(P<0.05)。至术后一周没有出现严重并发症。 结论 新型导丝系统用于经皮房间隔缺损封堵治疗不但安全有效,而且有利于降低操作难度。

Objective To evaluate the efficacy and safety of a novel wire for echo-guiding percutaneous atrial septal defect (ASD) closure. Methods Twenty experimental sheep were randomly divided into two groups, namely, the study and the control group, ten in each group. In both groups, an animal model of atrial septal defect was established by transthoracic balloon dilatation, and percutaneous closure of atrial septal defect was underwent by only echography guiding. The total procedural time; passing time (time needed for the guide wire to enter the left atrium); frequency of delivery sheath dropping into right atrium; frequency of arrhythmias; and rate of complications were compared between the two groups. Results All animals survived defect creation procedures uneventfully. ASD devices were successfully implanted in all sheep. The study group vs. control group had significantly (P<0.05) lower: mean procedure time (15.36±4.86vs. 25.82±7.85 min); mean passing time (2.69±0.82 vs. 5.58±3.34 min); frequency of guide wire dropping into right atrium (0% vs. 40%); and frequency of atrial (4.41±2.61 vs. 9.60±3.68) or ventricular premature contractions (0.75±0.36 vs. 1.34±0.68), respectively; without serious complications up to one week. Conclusion The novel wire system is not only safe and effective in the treatment of ASD occlusion, but also easy to operate.

关键词: 房间隔缺损; 超声心动图; 新型导丝; 经皮介入

Key words: atrial septal defect; echocardiography; new guide wire; percutaneous Intervention

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