| Objective:To investigate the changes of left ventricle function and hemodynamics after transcatheterizition of four common congenital heart diseaseMethodsFrom March 2002 to December 2007,transcatheterizition of occlusure of congenital heart disease was performed in 534 patients(210 males and 324 females) age ranged from 3 to 79 years(mean 21.55±14.34 years).Of the subjects,there were 194 cases with perimembraneous ventricular septal defect(PMVSD),151 subjects with atrial septal defect(ASD),139 patients with patent ductus arteriosus(PDA) and 50 cases with pulmonary valve stenosis(PS).All were diagnosed by physical examination,chest X-ray and transthoracic echocardiography(TTE).There was 1 PMVSD case associated with ASD,2 PS patients with ASD and 1 PS subject with PDA.TTE was implied to measure the left atrial diameter(LA),left ventricle end-diastole diameter(LVEDD),left ventricle end-systole diameter(LVESD),pulmonary artery diameter(PD),aortery diameter(AD),pulmonary artery pressure(PAP) or pressure from right ventricle to pulmonary artery(ΔP),cardiac output(CO),stroke volume(SV),ejection fraction(EF),fraction shortening(FS) pre-operation and 3-day,1-month,1-year post-operative.Results(1) 180(83 males,97 females) of 194 PMVSD patients age ranged from 3-60 years(mean 15.11±10.01 years) were implanted VSD occluders,the diameter of PMVSD measured by left ventricle radiography was 2-15.3(5.09±2.14)mm and the diameter of occluders was 4-18(7.37±3.18)mm.There was 1 case with hemoglobinuria after the operation that was underwent surgery.All the occluders located in proper positions and their shapes were good in follow-up.LA,LVEDD,LVESD decreased significantly(p＜0.001)three days, one month and one year after occlusion.At same time PAP was decreased significantly(p＜0.001).PD did not change markedly,so and AD.CO and SV decreased significantly(p＜0.05).EF and FS did not change remarkably 3 days after surgery,but reduced markedly after 1 month and 1-year.(2) 139(39 males,100 females) of 151 ASD cases age ranged from 3-79 (30.49±17.43) years were implanted occluders successfully.The average diameter was 7-39(22.74±5.49)mm and the mean occluder diameter was 12-44 (27.45±5.97)mm.The occluders had not been found to move or drop.They did not influence mitral valve and tricuspid valve too.LA did not increased remarkably but LVEDD and LVESD increased significantly(p＜0.01) in follow-up.PD and PAP decreased remarkably(p＜0.05,p＜0.001) but AD increased significantly(p＜0.05) in follow-up.CO,SV,EF and FS increased significantly(p＜0.001) too.(3) 133(48 males,85 females) of 139 PDA patients age ranged from 3-65 (22.19±14.54) years were implanted PDA occluders.The successful rate was 95.7 percent.The occluders had not been found to move or drop and there was no recurrence and hemolysis.LA,LVEDD and LVESD deceased remarkably(p＜0.05) compared with pre-operative.PD deceased markedly in one-month follow-up but AD had no changes.PAP deceased significantly(p＜0.001) Three days,one month and one year after occlusion.CO and SV deceased remarkably(p＜0.05) but EF and FS deceased remarkably only in one year after occlusion(p＜0.05).(4) 46 PS cases including 24 males and 22 females age ranged from 4-60(18.07±13.39)years were performed percutaneous balloon valvuloplasty of pulmonary valve stenosis(PBPV).4 patients did not undergo PBPV because of the smallΔP.One patient had ventricular fibrillation during the balloon dilated and recovered with the balloon pulled out.LA,LVEDD and LVESD increased little in follow-up.PD decreased but had no statistics significance.AD did not change remarkably.PAP decreased significantly (p＜0.001) in three days,one month and one year follow-up.The increase of CO,SV,EF,FS had no statistics significance.ConclusionTranscatheterizition of four common congenital heart disease is safety and efficiency.It can improve the left ventricle function and hemodynamics.
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