本研究目的在於評估以關閉器關閉心房中隔缺損後, 關閉器之位置, 心臟血
心房中隔缺損之病人, 在手術後6 個月至3.3 年後做電腦斷層檢查。這卅一例當
中在7 例接受Sideris 關閉器, 10 例以Starflex 關閉器及14 例Amplatzer 關閉器並
通暢, 二尖瓣及三尖瓣是否受影響。結果: 四例有部份肺靜脈迴流阻塞, ( 2 例為
Sideris 關閉器, 1 例Starflex, 另一例使用Amplatzer 關閉器 ), 其中有一例使用
Sideris 關閉器者, 發生一個金屬框架 (Arm) 滑入肺靜脈。另一例也是Sideris
關閉器使用者, 框架移入下腔靜脈, 另一例Starflex 之框架穿過心房室中隔膜。
塞的情形, 但有四例可看到殘留的缺損及分流。結論: 電腦斷層影像可用於評估
We conduct the study to assess device position, cardiovascular structure and
morphology in patients who underwent transcatheter closure of atrial septal defect
Electron-bean computerized tomography (CT) was performed in 31 patients who
had undergone transcatheter ASD closure in this institution. The interval between
ASD closure and CT imaging study ranged from 6 months to 3.3 years. Of the the 31
patients, Sideris device was deployed in 7, Starflex device in 10 and Amplatzer device
in 14 patients. Three-dimensional reconstruction of the CT images was performed to
evaluate the device position, patency of systemic and pulmonary venous pathway and
morphology atrioventricular valves.
Partial obstruction of a pulmonary vein was observed in 4 patients (2 with
Sideris device, 1 with Starflex device and 1 with Amplatzer device). Migration of one
arm to a pulmonary vein was observed in 1 with Sideris device. Migration of one arm
to inferior vena cava was found in one with Sideris device. Impingement on
atrioventricular septum by one arm of Starflex device was found in 1. One had one
arm of Starflex device penetrating atrioventricular septum. One had residual shunt.
None had systemic vena cavae or coronary sinus obstruction. None had impingement
of device on mitral or tricuspid valve leaflets. Cross-sectional and Doppler
echocardiographic studies in the 31 patients showed none had significant pulmonary
or systemic venous pathway obstruction. A small left ventricle to right atrial shunt
was found in the patient who had impingement on the atrioventricular septum.
Trivial-to-mind residual shunt was found on the echocardiogram in 4 with Sideris
CT images can be useful in the assessment of device position and systemic and
pulmonary venous pathway in ASD patients following transcatheter closure.
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