先天性心脏病介入治疗失败后的手术治疗

    Surgical treatment of congenital heart disease with unsuccessful interventional treatment

    • 摘要: 目的:探讨先天性心脏病(先心病)介入治疗失败的原因及外科手术治疗的方法。方法:23例先心病患者接受介入治疗放置封堵器失败,4例介入治疗后封堵器移位。该27例在介入治疗失败后当日至3周内在体外循环下行封堵器取出术和(或)先心病纠治术。结果:手术效果满意,27例均未出现重要器官功能损害,心功能恢复至Ⅰ级。结论:先心病的介入治疗应严格掌握手术指征和选择合适的封堵器;封堵器移位是先心病介入治疗后较严重的并发症,一旦发生应紧急手术以避免病情恶化危及生命。

       

      Abstract: Objective: To investigate the reasons of unsuccessful interventional treatment for congenital heart disease and the method of surgical treatment.Methods: The interventional treatment failed in 23 patients with congenital heart disease,and in 4 patients the occluder was dislocated after interventional treatment.All of the 27 patients underwent surgical treatment including removal of the displaced occluder and/or the congenital heart disease repair on cardiopulmonary bypass on the same day of interventional treatment or three weeks later.Results: The results of surgical treatment were satisfying.All patients recovered,and the heart function was in NYHA class Ⅰ.Conclusions: The indication for the interventional treatment should be strict and the size of occluder should be correct.Occluder displacement is a severe complication after interventional treatment with congenital heart disease.Once the occluder is found dislocated a more aggressive strategy with emergent earlier surgical treatment is advocated before deterioration of heart function.

       

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