Objective To investigate the clinical effect and safety of domestic thin-waist-big-side ventricular septal defect occluder in treating ruptured sinus Valsalva aneurysm (RSVA). Methods Interven-tional occlusion therapy by using domestic thin-waist-big-side ventricular septal defect occluder with the size 1-2 mm bigger than the diameter of the ruptured hole determined on angiograph was carried out in four patients with sinus of Valsalva aneurysm that ruptured into the right heart circulation. Echocardiography, electrocardiography, routine blood and urine tests, liver and kidney function tests, etc. Were performed immediately, one and 7 days after the surgery. Follow - up checkups with echocardiography and electrocardiography were conducted at 30, 90 and 180 days after the surgery to evaluate the clinical effect. The results were analyzed. Results The diameters of the ruptured hole determined by echocardiog-raphy and ascending aorta angiography were (9.3 ± 3.6) mm and (8.7 ± 4.2) mm, respectively. Technical success was obtained in all patients. After the surgery, no complications such as hemolysis or aortic regurgitation were seen. Echocardiography performed at 7, 30, 90 and 180 days after the treatment showed that the inner-diameters of the right ventricular and right atrium were markedly reduced. The occluder had no undesirable effect on the aneurysm wall and the opening of coronary artery as well as on the aortic valve. Conclusion Transcatheter closure with domestic thin-waist-big-side ventricular septal defect occluder is a mini-invasive, safe and effective therapy for ruptured sinus Valsalva aneurysm.%目的 观察应用国产小腰大边型室间隔缺损封堵器经导管治疗主动脉窦瘤破裂的临床疗效及安全性.方法 收集4例主动脉窦瘤破入右心系统的患者,根据造影结果选择较破口直径大1 ～2 mm的国产小腰大边室间隔缺损封堵器进行封堵.观察介入封堵术即刻及术后1、7d的超声心动图、心电图、血尿常规、肝肾功能等变化,并于术后第30、90、180天随访观察超声心动图、心电图等的变化.结果 超声测量4例患者窦瘤破口直径为(9.3±3.6)mm,升主动脉造影测量窦瘤破口直径为(8.7±4.2)mm.术后无溶血、主动脉瓣反流等并发症.术后7、30、90、180 d超声心动图显示右心室、右心房内径均较术前明显缩小,封堵器对瘤壁及冠脉开口、主动脉瓣无影响.结论 应用国产小腰大边室间隔缺损封堵器经导管治疗主动脉窦瘤破入右心系统是一种微创、安全、有效的治疗方法.
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