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1、中國胸心血管外科臨壅塑查!!!!生!旦箜!!查塑型ChinJClinThoracC—ardiovascSurg,Septem—ber2007,V01.14,SuPpl戮攀褥蓐簿臻囊瑗矚醚壤鬟綴緩先心病室間隔缺損封堵治療前后胸部X線表現陳金明姚睿榮廖德寧錢建英陳懿吳宗貴(第二軍醫(yī)大學長征醫(yī)院心內科,上海200003)摘要:目的觀察膜周部室間隔缺損(VSD)封堵術前后的胸部X線表現,總結封堵器在常規(guī)胸片上的影像特點。方法分析資料完整的33例AmplatzerVSD雙面?zhèn)惴舛耉SD患者術前及術后4~7天內的胸部后前位及左側位X線胸片。結果大部分VSD
2、患者封堵術后后前位胸片上封堵器位于第8~9椎體正中線的左側,但形態(tài)上呈現1點、2點,偶可見1點1圈。側位上封堵器均位于膈肌脊柱交叉點與胸骨角連線的左前方,多呈兩點,部分呈“H”形。封堵術后短期內即出現肺部X線表現有不同程度的改善。結論正確安置的VSD封堵器在胸片上具有一定的顯影特征.常規(guī)胸片可以用來判斷VSD介入治療的療效以及封堵器的位置、形態(tài)。關鍵詞:室間隔缺損;介入治療;封堵器}胸部X線TheChestRadiographicAppearanceBeforeandafterTranscatheterClosureinPatientswith
3、VentricularSeptalDefectCHENJin-ming。YAORui—tong,LIAODe-ling,OJANJian-ying,CHEN玎,T礦UZong-ggi.(DepartmentofCardiology,ChangzhangHospital,Shanghai200003,P.R.China)Abstract:ObjectiveToexplorethechestradiographicappearanceofperi—membranousventricularseptaldefeCt(VSD)beforeandafte
4、rtranscatheterclosurewithAmplatzeroccluderandtoconcludetheradiographiccharacteristicsofVSDoccluderonchestradiography.MethodsPlainchestfilmsinposterior—anteriorviewandleftlateralviewwerestudiedin33patientsbeforeand4~7daysaftertranscatheterclosure.ResultsAftertheproceduremostV
5、SDoccluderswerelocatedbetweenT8andT9,leftofanteriormidlineonthepostero—anteriorroentgenogram.Theoccluderspresentedonedotortwodots。occasionallyonedotandonecircle.Onlateralchestradiographs,alloccluderslocatedtheleftanteriorofthelinebetweenthediaphragmandspinecrossingandthester
6、nalangle.Mostofoccluderspresentedtwodots。somewerelike“H”shape.Inmostpatients,thechestradiographicappearancewereimprovedtosomeextentaftertheprocedure.ConclusionTheventricularseptaldefectsoccludershaveacharacteristicradiographicappearancewhenproperlypositioned.Plainchestradiog
7、raphscanidentifytheeffectsoftranscatheterclosureandthelocationandshapeofoccludersinpatientswithVSD.Keywords:Ventricularseptaldefect;Interventionaltherapy,OccluderIRadiography室間隔缺損(VSD)為最常見的先天性心臟病之一,盡管外科手術的死亡率很低,但由于其創(chuàng)傷大、遺留手術疤痕及需要體外循環(huán)等原因,已逐漸被經導管介入封堵所取代。Amplatzer封堵器及類似的國產封堵器治療已
8、成為膜部VSD的首選治療手段[1]。術后隨訪是VSD封堵的重要組成部分,胸部X線檢查為VSD介入治療前后的重要檢查,它不僅能夠反映治療前后肺部體征的變