Clinical efficacy analysis of different interventional approaches for patent ductus arteriosus in children (≤7 years) / 中国胸心血管外科临床杂志

@#Objective    To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children. Methods    The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results     A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications. Conclusion    It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

Application and Assessment of CT Scanning in Percutaneous Pulmonary Valve Implantation / 中国循环杂志

Objective: To assess the application value of CT scanning in percutaneous pulmonary valve implantation (PPVI). Methods: A total of 19 patients with severe pulmonary regurgitation planed to receive PPVI in our hospital from 2014-05 to 2016-07 were studied. CT scan and transthoracic echocardiography (TTE) were conducted to collect the data of pulmonary root anatomy and to compare the difference of pulmonary annulus size measured by CT and TTE. The accuracy of pre-operative measurement was evaluated by the follow-up study at (1-26) months after the operation. Results: In all 19 patients, the mean anatomic measurements by CT were as follows: diameter of pulmonary annulus (24.3±3.5) mm, diameter of pulmonary sinotubular junction (25.4±4.0) mm, diameter at distal of main pulmonary artery (27.5±4.8) mm, diameter of right ventricular outflow tract (36.8±7.3) mm, length of main pulmonary artery (45.5±7.0) mm, diameter of left pulmonary artery (17.9±1.5) mm and diameter of right pulmonary artery (18.5±3.6) mm. The diameter of pulmonary annulus measured by CT was larger than TTE, P<0.05. During (1-26) months follow-up period, no patients suffered from stent fracture or translocation, peri-pulmonary valve regurgitation, obvious pulmonary regurgitation or coronary stenosis; 1 patient had increased flow rate at right pulmonary artery opening by stent blocking and 2 patients had residue mild stenosis of pulmonary valve. Conclusion: Pulmonary annulus size measured by CT and TTE was different; CT may precisely assess the morphology of pulmonary root with adjacent area which is important for pre-operative evaluation in PPVI patients.

Short and Mid-term Efficacy of Device Closure of Patent Foramen Ovale for Treating the Patients With Patent Foramen Ovale Combining Cryptogenic Stroke and Transient Ischemic Attack / 中国循环杂志

Objective: To explore the short and mid-term efficacy of device closure of patent foramen ovale (PFO) for treating the patients with PFO combining cryptogenic stroke (CS) and transient ischemic attack (TIA). Methods: A total of 56 PFO patients with CS and TIA receiving device closure in our hospital from 2009-05 to 2015-12 were retrospectively studied. Transthoracic echocardiography (TTE), electrocardiogram (ECG), chest X-ray were examined at 24h, 1 month, 3 and 6 months after theoperation; telephone visit was conducted every 6 months thereafter. Results: There were 54/56 PFO patients combining CS and 2 combining TIA; 53 (94.6%)patients received PFO occluder from Starway medical technology. Aspirin was used for 6 months after the operation. The patients were followed-up for the average of (34.67±23.24) months. No body suffered from post-operative stroke and TIA; no residual shunt was observed. Conclusion: The short and mid-term efficacy of device closure has been satisfactory for treating the patients with PFO combining CS and TIA; its overall clinical value should be further investigated in large population and long-term study.

Transcatheter closure of anastomotic leakage after surgical procedures for noninfected ascending aortic pathology / 中华放射学杂志

Objective To evaluate the safety and efficiency of transcatheter anastomotic leakage closure after surgical procedures for non-infected ascending aortic pathology with different occlusion devices. Methods From Dec. 2013 to Sep. 2015, six cases received interventional therapy for anastomotic leakage after surgical procedures for non-infected ascending aortic pathology using occluders. Four cases were with proximal graft-vessel anastomotic leakage, including two pseudoaneurysms at the site of aortic roots and two ascending aorta to right atrium shunts. The other two cases were with artificial grafts to intraoperative stent anastomotic leakage leading to endoleak type Ib. The anastomotic leakage was totally occluded by single ADOⅡrespectively in four cases. Two detachable coils were implanted in one case with artificial graft to intraoperative stent anastomotic leakage, but mild residual shunt to false lumen was detected by DSA and follow-up CTA. The second interventional procedure was carried out one month later, and one ADO Ⅱ was used to close the residual leakage totally. One PDA occluder was implanted along arteriovenous guide-wire track via aortic root to right atrium fistula in one case. Results All the anastomotic leakages of the six cases were totally excluded by different occlude devices percutaneously. The technical success rate was 100%. Follow-up time was from 1 month to 4 years. The patients' clinical condition improved obviously. Follow-up CTA showed no recurrence of anastomotic leakage. Complete thrombosis and marked shrinkage of the pseudoaneurysm were achieved in two cases, and the partial thrombosis and shrinkage of the false lumen were achieved in 2 cases. Conclusion Trans-catheter closure is an alternative treatment for ascending aortic surgical anastomotic leakage, which may achieve satisfactory short-and mid-term results.

Clinical Features in Patients With Hypertrophic Cardiomyopathy Combining Left Ventricular Apical Aneurysm / 中国循环杂志

Objective: To analyze the clinical features in patients with hypertrophic cardiomyopathy (HCM) combining left ventricular apical aneurysm (LVAA) . Methods: A total of 1194 HCM patients treated in our hospital from 2007-01 to 2013-01 were studied. There were 23 (1.93%) patients combining with LVAA including 19 male and 4 female; coronary artery disease (CAD) was excluded and the patients received echocardiography and coronary angiography (CAG) examinations. Results: There were 21/23 LVAA patients having left mid-ventricular obstruction and 7 of them combining simultaneous left ventricular outflow obstruction.The average pressure gradient in those 21 patients was (56.8 ± 12.9) mmHg and the rest 2 patients suffered from apical hypertrophic cardiomyopathy.The mean maximum thickness of left ventricular wall was (21.8 ± 6.3) mm and the dimension of left ventricle was (39.4 ± 5.2) mm. Electrocardiography showed that 3 patients had paroxysmal ventricular tachycardia;CAG indicated that 6 patients combined with coronary artery muscular bridge at left anterior descending (LAD) artery. The patients were followed-up for (2.7 ± 1.3) years and adverse cardiovascular events occurred in 5 patients during that period. Conclusion: HCM combining LVAA was most frequently happened in patients with left mid-ventricular hypertrophic cardiomyopathy, some of them combining simultaneous left ventricular outflow obstruction and had the higher occurrence rate of adverse cardiovascular events. Early and accurate diagnosis is very important for guiding clinical treatment.

Cardiac Functional Changes in 8 Patients After Percutaneous Pulmonary Valve Implantation / 中国循环杂志

Objective: To evaluate the changes of left and right ventricular function in patients after percutaneous pulmonary valve implantation (PPVI). Methods: A total of 8 patients with successful PPVI in our hospital from 2014-05-27 to 2015-03-25 were studied. The patients received pre-operative evaluation including clinical symptoms, plasma BNP levels, ECG, chest X-ray, echocardiography, CT and MRI examinations. Post-operative follow-up study was conducted at 6 months after PPVI to compare the ventricular functional changes. Results: The average age in 8 patients was 14-42 (25.4±8.1) years including 7 with tetralogy of Fallot correction and 1 with pulmonary stenosis plasty for 24 years. Echocardiography found that 3 patients with mid to large pulmonary regurgitation and 5 with large regurgitation. Compared with pre-operation, at 6 months after PPIV, all patients had decreased right ventricular end-diastolic diameter (RVEDD) as (44.0±4.8) mm vs (33.6±7.1) mm, right ventricular end-diastolic volume index (RVEDVI) (150.1±25.7) ml/m2 vs (111.4±39.1) ml/m2, RVESVI (107.8±21.5) ml/m2 vs (80.7±22.2) ml/m2 and right ventricular cardiac output (RV-CO) (6.8±1.3) L/min vs (4.9±0.8) L/min, but right ventricular ejection fraction (RVEF) was similar (40.5±6.2) % vs (39.5±9.9) %, P>0.05; while increased LVEDD (42.9±4.4) mm vs (46.1±3.0) mm, P0.05. Conclusion: PPVI may decrease right ventricular preload, improve its reverse remodeling and maintain systolic function at normal level in relevant patients; while the impacts on left ventricular function and geometry should be further studied.

Clinical study application of Amplatzer duct occluder Ⅱ to occlude aortopulmonary collateral arteries / 中国介入心脏病学杂志

Objective To assess the feasibility and efficacy of Amplatzer duct occluder Ⅱ (ADOⅡ) in occlusion of aortopulmonary collateral arteries. Methods Seven patients,6 males and 1 female, with aortopulmonary collateral circulation diagnosed previously by cardiac Computed Tomograpy or cardioangiography from Mar 2014 to Apr 2015 were enrolled. All of them were treated with ADO Ⅱ. Results The age of the patients ranged between 5 - 71 months old and weight 4. 2 - 22. 0 kg. Successful hybrid approach was achieved in 6 of 7 patients. One patient failed the occlusion because of severe hypoxemia and mild-moderate residual shunt after catheter intervention. Total 15 aortopulmonary collateral vessels were embolized by 7 ADO-Ⅱ, 22 non-detachable coils ( Cook corp. ) and 2 detachable micro-coils ( Boston Scientific corp. ). Complete embolization was achieved in 2 patients,4 patients had mild residual shunt and 1 patient had mild-moderate residual shunt after the embolisation. No interventional complications recorded. Conclusions ADO Ⅱ has high controllability and suitable for application through small delivery catheter for minimally-invasive procedures to the vessels. It is a preferable alternative in treating pediatric patients with large and tortuous aortopulmonary collateral arteries.

Observation and nursing of the complications after the treatment of endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy combined with laparoscopic cholecystectomy for the patients suffered from gallstone disease combined with comm / 中国实用护理杂志

Objective The research aimed to probe into the complications of the treatment that endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy (ERCP/EST) combined with laparoscopic cholecystectomy (LC) for the patients suffered from gallstone disease combined with common bile duct stones and investigate the nursing methods.Methods One hundred and twenty-four patients suffered from gallstone disease combined with common bile duct stones were included in this retrospective analysis.At first,they underwent the treatment of ERCP/EST,and underwent LC in 1 to 5 days later.All the clinical data were collected and analyzed.Results Of all the patients,104 patients successfully underwent the treatment of ERCP/EST.And of the 104 patients,100 patients successfully underwent LC,the other 4 patients underwent open cholecystectomy.Nineteen complicated with acute pancreatitises,one with hemorrhage and two suffered from infections of bile duct were observed in this study.Conclusions Combination of ERCP/EST with LC is a safe and effective treatment for gallstone disease combined with common bile duct stones.The preoperative psychological counseling,and the surveillance and nursing of complications play significant roles in the successful treatment.

Balloon dilation of pulmonary valve stenosis with 10 F domestic balloon catheter in children≥10 kg / 中国介入心脏病学杂志

Objective To assess the safety and efficacy of balloon dilation of pulmonary valve stenosis with 10 F domestic balloon catheter in children ≥ 10 kg. Methods From May 2009 to June 2014, eighty-three consecutive children with weight ≥ 10 kg and age of (4.5±2.8)(ranged from 1-12) years underwent percutaneous balloon pulmonary valvoloplasty(PBPV) with 10 F domestic balloon catheter. Indication for treatment, procedural details, catheterization data, complication rate, peak-to-peak systolic gradient across the valve and pulmonary insufficiency on echocardiography were respectively analyzed. Forty-four patients were followed up 6-44 months after procedure. Results All procedures were completed successfully. The peak-to-peak systolic gradient across the pulmonary valve decreased from (67.7±26.2) mmHg to (15.4±11.6) mmHg (P < 0.01) immediately after PBPV. Two patients developed reactive infundibular spasm after dilation. They were relieved at 6 months post PBPV. No patient had severe pulmonary insufficiency, tricuspid regurgitation or reintervetion. Conclusions PBPV with 10 F domestic balloon catheter in children with weight≥10 kg is a safe and effective method.

Transcatheter closure treatment for patients with atrial septal defect complicated by atrial fibrillation:a postoperative follow-up study / 介入放射学杂志

Objective To explore the prognosis and management of atrial fibrillation (AF) in patients with atrial septal defect(ASD) accompanied by AF after transcatheter closure of ASD. Methods During the period from July 2010 to May 2013, a total of 24 patients with ASD accompanied by AF were admitted to authors’ hospital to receive transcatheter closure of ASD. Electrocardiogram (ECG), chest X-ray film and transthoracic echocardiography (TTE) were performed before and one day after the operation. Follow-up information was obtained through telephone or at out-patient clinic interview. Results Successful occlusion of ASD was obtained in all patients, and in no patient the AF rhythm turned to sinus rhythm after the procedure. In one patient preoperative AF turned to postoperative atrial flutter, and AF recurred in one case who had received transcatheter ablation of AF before the procedure. One female patient developed gastric bleeding during the course of orally taking warfarin, and she died of cerebral infarction at three days after ceasing the use of warfarin. Of the 24 patients, no anticoagulant drug was used in 5 (20.8%), oral administration of aspirin was given in 7 (29.2%), and oral medication of warfarin was employed only in 11 (45.8%). Conclusion The spontaneous conversion rate of AF is very low in patients with ASD complicated by AF after transcatheter closure of ASD. Postoperative medication of anticoagulation should be strictly standardized and carefully managed.

Application of Echocardiography for Occluding the Multiple Seconded Atrial Septal Defects in Relevant Patients / 中国循环杂志

Objective: To evaluate the effect of echocardiography for occluding the multiple seconded atria1 septal defects ( MASD) in relevant patients. Methods: A total of 42 MASD patients were selected by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). The transcatheter closure was monitored by TTE and X-ray, the effect of treatment was evaluated by TTE, ECG and chest X-ray at 24 hours and 1, 3, 6 months after the procedure. There were 38 patients with 2 defects, 3 with many central small defects and 1 with 3 defects. The patients included 17 male and 25 female with the mean age of (32.6 ± 13.4) years. Results: The size and distance of the defects were measured with 4 cardiac chambers cross sectional study. The mean diameter of bigger defect from up to down was (9-27) mm, with the mean of (20.7 ± 6.1) mm, from front to back was (8-23) mm, with the mean of (16.9 ± 5.7) mm;the mean diameter of small defect from up to down was (3-12) mm, with the mean of (6.8 ± 3.6) mm. The length of the defect interva1 was (4-18) mm, with the mean of (7.9 ± 2.6) mm. There were 4 patients with 2 defect interval at 8.7 mm who received 2 occluders without post-operative lfow shunt. The rest 38 patients received 1 Amplatzer occluder which was (14-36) mm with the mean of (25.1 ± 6.4) mm which was (6.9 ± 1.7) mm larger than echocardiographic prediction. The success rate of implantation was 100%. There were 17 (40.5%) patients with post-operative lfow shunt. The patients were followed-up for (6-36) months, with the mean of 18.7 months, there were 11 (26.2%) patients with small amount of lfow shunt at 3 months after the operation. Conclusion: Echocardiography is important for choosing the type and size of occluder devices, in-operative monitoring and post-operative effect evaluation for treating the ASD patients.

Assessment of atrial septal defect size with three-dimensional volumetric measurement of cardiac CT: comparison with size of the postoperative occluder / 中华放射学杂志

Objective To evaluate two kinds of practical CT three-dimensional volumetric measurement techniques in assessing atrial septal defects (ASDs) for transcatheter device closure.Methods Retrospective assessment of 50 consecutive patients who underwent ASD closure was conducted.Cardiac CT was performed in them before planned transcatheter ASD closure and postoperative chest radiograph was performed in both posteroanterior and lateral view.Coronary CT angiography was made for the detection of coronary artery disease,and three-dimensional reconstruction of ASD was conducted for determination of the defect size in the GE-workstation.Two kinds of practical CT three-dimensional volumetric measurement techniques,one named CT virtual endoscopy assisted volumetric measurement (CTVE) and another called axial sequence assisted volumetric measurement(CTAS),were used to calculate the major axis and the minor axis of the ASD respectively.Thus,the dimensions of the Equivalent Circle were derived,with circunference and area equal to the elliptic ASD according to the formulation (D =√b4/a2 + a2-b2).The ASDs occluder (ASO) dimension was measured in the lateral chest radiograph,and this postoperative occluder-waist size (POS) value was regarded as the gold standard for the measurement of ASD.The results were compared between CTVE and CTAS,and the correlations were evaluated between them and the gold standard.Results The differences in the major dimensions (-9.05 mm,t =-6.60,P ＜ 0.05),minor dimensions (-4.86 mm,t =-4.39,P ＜ 0.05) and Equivalent circle dimensions (-7.65 mm,t =-6.40,P ＜ 0.05) of ASD between CTAS and CTVE were statistically significant.Though the CTAS cannot provide the en face views of ASDs,the Equivalent Circle dimensions measured by CTAS(22.48 ± 5.59) mm was correlated well with POS (27.07 ± 6.83)mm (Y =1.14X + 1.39,r =0.94,P ＜ 0.01),and a good correlation was found between this Equivalent Circle dimensions and ASO size (Y =1.02X + 6.84,R2 =0.78,r =0.88,P ＜ 0.05).The correlation between the Equivalent Circle dimensions measured by using CTVE (30.13 ± 9.27) mm and POS was poor (Y =0.30X + 17.94,r =0.41,P ＜ 0.01),though it can provide the en face views of ASDs.Conclusion CTVE and CTAS are two complementary techniques of assessing ASDs for transcatheter device closure.

Assessment of transcatheter closure of coronary artery fistula by transthoracic echocardiography / 中华超声影像学杂志

Objective To investigate the efficacy of transcatheter closure of coronary artery fistula (CAF) by transthoracic echocardiography(TTE) and the role of TTE in this therapy. Methods CAF were occluded with transcatheter closure techniques in 17 patients. TTE was performed before and after the treatments. The key points were retrospectively analyzed including: the sites of CAF, the position and diameter of CAF,the shape and position of the devices after the intervention,the residual shunt,and cardiac chamber size. Results Before the therapy,TTE made definite diagnosis of CAF. All patients had lesions in single coronary artery, and the diameter of CAF was 2-14 (6.4 ± 3.5)mm. All patients underwent transcatheter closure successfully. TTE revealed the shunts disappear 1-4 days after the occlusion. During a follow-up period of 1- 29 (11.7± 7.9)months,no residual shunts, no complications, and normal size of thecardiac chambers were recognized by TTE. Conclusions The transcatheter closure of CAF has emerged as a less invasive, safe and effective strategy. Echocardiography has important role in primary screening of patients and the follow-up after the treatments.

Imaging of cardiovascular malformations in Williams syndrome / 中华放射学杂志

Objective To evaluate the imaging methods for cardiovascular malformations in Williams syndrome(WS).Methods Thirteen cases of WS(7 males and 6 females)aged 10 months to 13 years were involved in this study.All patients underwent chest X-ray radiography,electrocardiography.echocardiography and physical examination.3 cases underwent electronic beam computed tomography (EBCT),cardiac catheterization and angiography were performed in 8 cases.Results Twelve patients were referred to our hespital for cardiac murmur and 1 cnse for cyanosis after birth.7 patients were found with "elfin-like"facial features.6 patients with pulmonary arterial stenosis.2 Cases with patent ductus arteriosus.2 case8 with 8evere pulmonary hypertension and 1 case with total endocardial cushion defect.Sudden death occurred in 2 patients during and after catlleterization.respectively. Conclusions Conventional angiography is the golden standard for the diagnosis of cardiovascular malformations in WS.Noninvnsive methods such as MSCT and MRI should be suggested because of the risk of sudden death in conventional angiography.

Prevention and management of complications during and after catheter closure of ventricular septal defect / 中国介入心脏病学杂志

Objective To approach the cause and treatment of complications during and after catheter closure of ventricular septal defect(VSD).Methods Catheter closure of ventricular septal defect was attempted in 415 patients.Among them,74 patients with complications were retrospectively analyzed.Results The overall complication rate was 17.83%(74/415).The complications during procedure were seen in 13.98%(58/415) which included arrhythmias in 11 patient,aortic regurgitation in 15 patients,residual shunt in 26 patients,displacement of closure device in 1 patients,cardiac temponade in 1 patient,tricuspid valve injury in 1 patient,mitral valve injury in 1 patient,iatrogenic VSD in 1 patient and respiratory complication in 1 patient.The complications after procedure were noted in 4.19% of the patients(16/382),including arrhythmias in 8 patients,LV enlargement in 2 patients,thrombus fomation in femoral artery in 2 patients,Ⅲ?AVB in 2 patients whom required temporary and permanent pacemaker implantation,respectively,headache in 4 patients,haemolysis due to residual shunting in 2 patients,tricuspid valve injury in 1 patient and puncture site bleeding in 1 patient.There was no death recorded in our study.Conclusion The incidence of complications during and after catheter closure of ventricular septal defect was relatively low but careful long term follow-up is necessary for the monitor of delayed complications.

Imaging diagnosis study of anomalous origin of coronary artery from the pulmonary artery / 中华放射学杂志

Objective To evaluate the imaging diagnosis of anomalous origin of coronary artery from the pulmonary artery(ACAPA).Methods A total of 11 cases with ACAPA were included in the present study.Chest films,echocardiography,cardioangiography,and electron beam computed tomography (EBCT) were employed as diagnostic modalities.Macroscopic anatomy at operation was referred. Results Ten cases were classified as anomalous origin of left coronary artery from the pulmonary artery(ALCAPA) and 1 case as anomalous origin of right coronary artery from the pulmonary artery(ARCAPA).They could not be diagnosed by chest films,but could be diagnosed by echocardiography in 3 cases,by EBCT in 1 case,and by cardioangiography in all cases.In ALCAPA,cardioangiography showed that the left coronary arteries arising from the posterior sinus or posterior wall of the pulmonary artery were perfused retrogradely via the collaterals from the dilated right coronary artery.In ARCAPA,the right coronary artery originated from the right sinus of the pulmonary artery.Gross anatomy at operation showed that the sites of the anomalous origins were the same as that of cardioangiography.Ischemic fibrosis of the anterior papillary muscles,mitral valve annulus enlargement,and prolapse of mitral valve,which led to mitral valve insufficiency,were found in 3 cases.Conclusion Chest film has limitation in the diagnosis and echocardiography should be further improved.Cardioangiography remains the “gold standard” of the preoperative diagnosis.

Transcatheter closure of patent ductus arteriosus with severe pulmonary arterial hypertension in adults / 中华放射学杂志

Objective To evaluate the effect of self-expandable occluder on closure of patent ductus arteriosus(PDA)with severe pulmonary arterial hypertension(PH)in adults.Methods Twenty-eight adult patients underwent transcatheter closure of PDA at a mean age of(31.3?11.6)years [(18—58)years].Either Amplatzer duct occluder or domestic device was used in the present study.X-ray,EKG and UCG were repeated in one day,one month,three months,and six months.Results Twenty of the 28 patients had successful occlusion,and the other 8 patients were given up.In the successful group,the narrowest diameter of PDA was(10.4?2.7)mm [(6—16)mm],the diameter of selected occluder was(15.6?3.2)mm [(10—20)mm] at the end of pulmonary artery.Systemic artery oxygen saturation(SAsat)before and after oxygen inhalation was(93.5?1.8)%,(98.2?1.8)%,respectively(P

The prevention and management of complications during and immediately after percutaneous balloon mitral valvuloplasty / 介入放射学杂志

Objective To approach the cause and treatment of complications during and immediately after percutaneous balloon mitral valvuloplasty. Methods One thousand three hundred and eleven patients with mitral stenosis were treated by percutaneous transseptal balloon mitral valvuloplasty. Among them, 42 patients with complications were retrospectively analyzed. Results The overall complications rate was 3.2% (42/1 311) including atrial fibrillation 0.8%(10/1 311), acute pericardial tamponade 0.31%(4/1 311), severe mitral insufficiency 0.46% (6/1 311), femoral arterial venous fistula 0.69% (9/1 311), acute pulmonary edema and iatrogenic atrial septal defect 0.23%(3/1 311), respectively. Coronary air embolism, arterial thrombosis and transient cerebrovascular accident was 0.15%(2/1 311) for every other one. Balloon rupture was 0.08%(1/1 311).Conclusions The complications of percutaneous balloon mitral valvuloplasty rarely occur. It is a safe and efficient nonsurgical method for treating rheumatic mitral stenosis.