SUN Bao , CHENG Duan , LI Bo , HE Guibao , WANG Haifeng , Ahati , Elias , SHENG Xi , LI Jinpeng
  • Department of Cardiac Surgery, Xinjiang Cardiac and Neurovascular Disease Hospital, Urumqi, 830011, P.R.China;
CHENG Duan, Email: chengduan@126.com
Structural heart disease; congenital heart disease; chocardiography; femoral artery; femoral vein; interventional therapy
10.7507/1007-4848.202004027
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Objective To investigate the clinical efficacy and application value of percutaneous interventional treatment for structural heart diseases under guidance of ultrasound.Methods The clinical data of 1 010 patients with structural heart diseases treated by transcutaneous ultrasound-guided occlusion in our hospital from December 2, 2015 to December 31, 2019 were retrospectively reviewed, including 360 males and 650 females, aged 1-50 years. There were 692 patients of atrial septal defect (603 with central type, 9 combined with arterial catheter, 80 with ethmoid type), 116 patent foramen ovale, 25 ventricular septal defects (3 combined with atrial septal defect), 132 patent ductus arteriosus, 32 pulmonary valve stenosis (3 combined with atrial defect), 1 main pulmonary artery window, and 3 aneurysm rupture of aortic sinus. All patients were diagnosed by transthoracic echocardiography (TTE) before operation. Treatment was accomplished intraoperatively through TTE or transesophageal echocardiography (TEE) via the femoral artery or femoral vein. After operation, echocardiography, electrocardiogram and chest radiograph were reexamined.Results Satisfactory results were obtained in 1 005 patients, and 1 patient failed to seal the ventricular defect and was repaired under direct vision, occluder detachment occurred in 5 patients after operation (3 patients of atrial septal defects underwent thoracotomy for Amplatzer device and were repaired, 1 patient of atrial septal defects was closed after removing Amplatzer device, 1 patient of patent ductus arteriosus underwent thoracotomy for Amplatzer device and was sutured), mild pulmonary valve regurgitation occurred after balloon dilation in 2 patients with pulmonary stenosis, a small amount of residual shunt was found in 2 patients with ventricular defect, which disappeared after 3 months of follow-up, and 1 patient of right bundle branch block occurred and disappeared after 1 week. After follow-up of 1-24 months, 3 patients of ethmoidal atrial septal defect were reexamined with mild shunt. The occluder was in good position and the pressure difference of pulmonary valve was significantly reduced. There was no complication such as hemolysis, arrhythmia, embolism or rupture of chordae tendinae.Conclusion Percutaneous transfemoral artery and vein guided by TTE or TEE is safe and effective, with little trauma, no radiation or contrast agent damage, and has significant clinical efficacy and application values.

Citation： SUN Bao, CHENG Duan, LI Bo, HE Guibao, WANG Haifeng, Ahati, Elias, SHENG Xi, LI Jinpeng. Clinical efficacy and application value of percutaneous interventional treatment for1 010 patients with structural heart diseases under guidance of ultrasound. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(8): 921-927. doi: 10.7507/1007-4848.202004027 Copy

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