Evaluation Of Interventional Therapy In The Congenital Heart Diseases By Domestic Occluder: Analysis Of 36 Cases

BackgroundCongenital heart disease (CHD) which influences patients'mind and body health is a kind of the common cardiovascular disease. In order to improve the existence rate and the existence quality of the patients, discovering, diagnosing and treating early is very important. Conventional surgery is already quite mature, but it's required cardiopulmonary bypass (except the patent ductus arteriosus), major truma and long hospital stay, surgical scars evident, and there are some complications related to it. In the last century 50's, seldinger and his colleagues used puncture, duide wire and catheter methods for intravascular catheter operation which marked that a new, minimally invasive and effective treatment of the congenital heart disease began to form. With the continous improvement of intervention equipment, the accumulation of experience and the improvement of operation technology, it gradually formed a scientific, standardized interventional cardiology, but its development in China was limited by the expensive imported materials. Successful development of domestic closure device that greatly reduces the cost of the treatment makes intervention widely used and pulls the treatment of congenital heart disease to a new peak in our country.ObjectiveTo evaluate the therapeutic result and safety of domestic occluder in transcatheter closing congenital cardiovascular diseases (CCD).MethodsIn 36 patients with CCD, there were 18 cases of patent ductus arteriosus(PDA),11 cases of atrial septal defect (ASD),6 cases ventricular septal defect (VSD) and 1 case of residual shunt after repair of VSD, diagnosed finally by clinical manifestation, laboratory examinations and transthroracic echocardiography (TTE).All the defects were closed by Transcatheter approach with the domestic occluder under X ray, fluoroscopy angiography and TTE. Immediately, fluoroscopy angiography and TTE were used to evaluate the effectiveness after the procedure. TTE and electrocardiography (ECG) were applied at 72 hours,1 month,3 months and 6 months after the procedure in order to evaluate the effectiveness too.Results35 patients(97.2%) were treated successfully without any complications except the one with residual shunt after repair of VSD. Because he was proved that he was not suitable to cure his disease with interventional therapy after the cardiac catheterization angiography. There was no residual shunt and recanalization proved by the immediate fluoroscopy angiography and TTE,no deaths and no one case to need emergency surgery too. Postoperative follow-up showed that:â‘ ventricular diameter reduced in varying degrees;â‘¡the left ventricular ejection fraction changed in different degrees to normal range;â‘¢the pulmonary arterial pressure of the 10 cases with pulmonary hypertension decreased to normal range;â‘£all the occluders fixed well.ConclusionInterventional therapy with new homemade occluder is an efficient, minimally invasive, simple, safe method for the patients with congenital heart diseases.