| Objective:Minimally invasive percutaneous closure of atrial septal defect has been widely applied.At the present,there are two operative approaches:one is guided by complete ultrasonic cardiogram(UCG)and the other one is guided by digital subtraction angiography(DSA).The former is used earlier in clinic,so it has mature technology and exact curative effect.The latter is a new technique developed in recent years,so its curative effect is unclear.we collected the baseline characteristics and related indicators of 66 patients with PCASD guided by UCG to compare with percutaneous closure of atrial septal defect(PCASD)guided by DSA over the same period,and we analyzed separately the ultrasonic cardiogram data of PCASD guided by UCG to explore the efficacy and feasibility of PCASD guided by complete UCG.Methods:We retrospectively analyzed 66 patients(experimental group)with PCASD guided by UCG in our hospital from January 2015 to December 2015,and collected the baseline characteristics,the maximum diameter of ASD,occluder model,the success rate of the operation,operation time,the peak of pulmonary artery pressure change,the incidence of short-term complications,the total cost of hospitalization,postoperative hospital stays and other related indexes,to compare with 82 patients(matched group)with PCASD guided by DSA over the same period;We analyzed separately changes in the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDd),pulmonary artery peak systolic pressure,left atrial diameter(LAd)and right ventricular diameter(RVd)between preoperative and postoperative 1 month,and between preoperative and postoperative 3 months in Experimental Group.Results:The differences of baseline informations between patients in experimental group and matched group are not statistically significant(P > 0.05),such as gender(male: 17/female : 49 vs male: 24/ female: 59,P=0.562),age(29.8±18.8years vs 34.6±19.4years,P=0.131),weight(46.5±20.0kg vs 51.4±16.6kg,P=0.137)and the maximum diameter of atrial septal defect(16.2±6.1mm vs17.8±8.0mm,P=0.320).Moreover,the two groups of patients’ differences of intraoperative and post-operation related indicators,such as the size of the occluder(25.2±8.8 vs 27.8±10.7,P=0.112),operation time(57.9±28.8min vs 51.5±26.7min,P=0.168),the incidence of short-term complications(6.1% vs 6.1%,P=0.993),pulmonary artery peak systolic pressure change(6.1±10.5mm Hg vs 7.2±11.6mm Hg,P=0.580)and post-operative hospital stays(5.1±2.6days vs 4.7±3.3days,P=0.365)are also not statistically significant(P > 0.05).And the operation success rate(97% vs 96.3%,P=0.833)(P < 0.05)between the two groups is similar.However,only the difference of total hospitalization cost(33865.7±5450.4RMB vs 28811.3±9728.6RMB,P=0.000237)is statistically significant(P < 0.05).In terms of data,the total hospitalization cost of matched group(27257.4 ± 6284.8RMB)was lower than the cost of experimental group(33968.6 ± 5464.5RMB).In experimental group,between preoperative and postoperative 1 mouth,the LVEF(68.7 + 6.3% vs69.8 + 6.8%,P=0.338)and the LAd(28.8 + 6.8mm vs29.4 + 6.9mm,P=0.623)are not significant difference(P > 0.05),but the difference of LVEDd(37.5 + 6.6mm vs39.9 + 7.3mm,P=0.045),RVd(30.8 + 9.4mm vs24.1 + 7.0mm,P=0.000)and pulmonary artery peak systolic pressure(38.1 + 15.3mm Hg vs31.6 + 11.4mm Hg,P=0.007)are statistically significant(P < 0.05);between preoperative and postoperative 3 mouths,the LAd(28.8 + 6.8mm vs30.4 + 8.6MM,P=0.233)is not significant difference(P > 0.05),but the difference of the LVEF(68.7±6.3% vs70.8±5.3%,P = 0.042)、the LVEDd(37.5±6.6mm vs42.4±6.3mm,P = 0)、the RVd(30.8±9.4mm vs22.1±5.5mm,P = 0)and the pulmonary artery peak systolic pressure(38.1±15.3mmhg vs29.2±10.0mmhg,P = 0)are statistically significant(P<0.05).Conclusion:PCASD guided by UCG has the advantages of short operation time,little surgical trauma and rapid postoperative recovery,which is the same to PCASD guided by DSA.It is feasible,safe and effective simultaneously. |
PDF Full Text Request