| Objective To investigate the effect of interventional occlusion operation on left-right shunt type congentional heart disease(CHD)in children including ventricular septal defect(VSD),atrial septal defect(ASD),cardiac structure and hemodynamics of patent ductus arteriosus(PDA),Evaluate the efficacy of interventional closure in children with left-to-right shunt CHD.Method To retrospectively summarize the clinical data of 75 children with CHD who were successfully treated by occlusion blockade in the Second Affiliated Hospital of Anhui Medical University from June 2011 to June 2016,aged 3-14 years 24 cases of VSD group,11 males and 13 females,the average age of 7.5 ± 3.3 years,with an average body weight of 22.1 ± 12.4kg,the average defect diameter of 10.8 ± 4.4 mm.ASD group 24 cases,15 males and 9 females,the average age of 6.2 ± 3.1 years,the average body weight of 21.9 ± 10.7kg,the average defect diameter of 6.4 ± 1.7mm.PDA group 27 cases,13 males and 14 females,mean age 8.2 ± 4.2 years,the average body weight 24.6 ± 11.9kg,the average defect diameter of 4.9 ± 2.5mm.Transthoracic echocardiography was used to examine the cardiac structure and hemodynamics of the three groups before and 3 days,1 month,3 months,6 months and 1 year after operation.Analysis of intervention and closure of the preoperative and postoperative occlusion of 3d-1 years after the traumatic cardioventral-related symptoms and care of patients with changes in the Nordic guidelines.Result 1.VSD group: LA,LV,and RV were significantly decreased(P<0.05)before and 3 days,1 month,3 months,6 months,and 1 year after closure.After 3 days,it was significantly decreased(P<0.05).There was no significant change at 3 months,6 months,and 1 year after surgery compared with 1 month after surgery(P>0.05).The PAP at 3 days,1 month,3 months,6 months,and 1 year after closure was significantly decreased compared with preoperative(P<0.05),and the postoperative 1 month remained significantly lower than that after 3 days(P<0.05).<0.05),3 months after surgery was significantly reduced compared with 1 month after surgery(P <0.05).There was no significant change at 6 months and 1 year after surgery compared with 3 months after operation(P> 0.05).The TVE,TVA and AV were significantly increased(P<0.05)3 days after closure,and were not significantly changed at 1 month,3 months,6 months,and 1 year after operation(P>0.05).PV,MVE,and MVA were significantly reduced(P<0.05)3 days after closure,and were not significantly changed at 1 month,3 months,6 months,and 1 year after surgery.(P>0.05).The MV(E/A),TV(E/A),LVEF,and LVFS at 3 days,1 month,3 months,6 months,and 1 year after closure were not significantly different from those before surgery(P>0.05).2.ASD group: LA,LV were significantly increased(P<0.05)3 days,1 month,3 months,6 months and 1 year after occlusion(P<0.05).One month after operation was significantly increased compared with 3 days after operation(P<0.05),and the changes at 3 months,6 months,and 1 year after surgery were not significant(P>0.05).The RV at 3 days,1 month,3 months,6 months,and 1 year after closure was significantly decreased compared with preoperative(P<0.05),and the postoperative morbidity was significantly reduced at 1 month after surgery(P<0.05),there was no significant change at 3 months,6 months and 1 year after operation compared with 1 month after operation(P>0.05).The PAP at 3 days,1 month,3 months,6 months,and 1 year after closure was significantly decreased compared with preoperative(P<0.05).The postoperative 1 month was significantly lower than the postoperative 3 days(P<0.05),3 months after operation was significantly decreased compared with 1 month after surgery(P<0.05).There was no significant change at 6 months and 1 year after surgery compared with 3 months after operation(P>0.05).The MVE,MVA,and AV at 3 days,1 month,3 months,6 months,and 1 year after closure were significantly higher than before surgery(P<0.05),and 1 month,3 months,and 6 months after operation.Both months and 1 year were not significantly different(P>0.05)from 3 days after surgery.The PV,TVE,and TVA at the 3 days,1 month,3 months,6 months,and 1 year after closure were significantly decreased compared with preoperation(P<0.05),and 1 month,3 months,and 6 months after operation.Both months and 1 year were not significantly different(P>0.05)from 3 days after surgery.The changes of MV(E/A),TV(E/A),LVEF,and LVFS at 3 days,1 month,3 months,6 months,and 1 year after surgery were not significantly different from those before surgery(P>0.05).3.PDA group: LA,LV were significantly decreased(P<0.05)compared with preoperative 3 days,1 month,3 months,6 months and 1 year after occlusion.It was significantly reduced at 3 days(P<0.05),and no significant change was observed at 3 months,6 months,and 1 year after surgery(P>0.05).The RVs at 3 days,1 month,3 months,6 months,and 1 year after closure were not significantly different from those before surgery(P>0.05).The PAP at 3 days,1 month,3 months,6 months and 1 year after closure was significantly lower than before surgery(P<0.05),and the postoperative 1 month remained significantly lower than the 3 days after operation(P<0.05).P<0.05),the postoperative 3 months continued to decrease significantly(P<0.05),and the postoperative 6 months and 1 year had no significant change compared with the postoperative 3 months(P>0.05)..The MVE,MVA,and AV at 3 days,1 month,3 months,6 months,and 1 year after closure were significantly decreased compared with preoperative(P<0.05),and 1 month,3 months,and 6 months after operation.Both months and one year were not significantly changed(P>0.05)compared with 3 days after surgery.3 days,1 month,3 months,6 months and 1 year after closure,TVE,TVA,PV were significantly increased(P < 0.05),1 month,3 months,6 months after operation.Both months and one year were not significantly changed(P>0.05)compared with 3 days after surgery.The LVEF,MV(E/A),TV(E/A),and LVFS at 3 days,1 month,3 months,6 months,and 1 year after closure were not significantly different from those before surgery(P>0.05).Conclusion 1.After interventional closure,the cardiac structure and hemodynamics of VSD,ASD and PDA groups all changed beneficially,and this change occurred 3 days after interventional therapy.The changes of cardiac geometry Changes from January to March tend to stabilize,and hemodynamic changes in addition to PAP in 3 to 6 months after the tend to be stable,the rest were in the 3d-1 months after surgery in the definition,and on behalf of the heart function Some indicators of interventional closure did not change significantly.2.Interventional closure can significantly improve the left heart in children with left heart bypass CHD cardiac structure and hemodynamics,is an effective treatment,it is worth promoting. |
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