使用Amplatzer间隔封堵器直接经导管关闭梗死后室间隔缺损：即刻结果及最长5年随访
Primary transcatheter closure of postinfarction ventricular septal defects with the Amplatzer septal occluder- immediate results and up-to 5 years follow-up
研究报道使用Amplatzer间隔封堵器直接关闭梗死后室间隔缺损的围术期及长期结果。1999年12月至2005年2月共11例患者（年龄52-81岁）尝试封堵。3例处于急性期且病情危重，虽成功植入装置但均在术后死亡。8例慢性期患者中，缺损完全关闭或残余分流轻微，症状显著改善，随访1-62个月均存活且心功能良好。结论认为经导管封堵可作为合适解剖条件患者的替代方案，但急性期患者不能改善生存。
为什么推荐给您：早期单臂研究，样本量小，属新器械的探索性应用，常规增量。
不需要生物学背景，多打比方
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摘要Abstract
AIM: To report the periprocedural and long-term results of using the Amplatzer septal occluder for primary closure of post myocardial infarction ventricular septal defects.
METHODS AND RESULTS: Transcatheter closure was considered in patients with significant left-to-right shunting and defect anatomy and location thought to be suitable for closure with such a device. From December 1999 until February 2005 eleven patients (9 males) aged 52-81 years (mean 67,9) underwent an attempted closure. The time from the onset of infarction to the procedure ranged between 2 days and 58 weeks (mean 15,4 weeks). There were three patients in an acute phase of infarction (three weeks or less). They were in critical condition and required inotropic and ventilatory support. Eight patients (all in a chronic infarction phase) were hemodynamically stable and in NYHA class III-IV (6 patients) or class II (2 patients). A successful device implantation occurred in all but one patient, in whom a 26 mm occluder pulled through a 16 mm defect on day 8 of infarction. An infarct exclusion surgery was successfully performed in this patient. In the remaining 10 patients, the defect size ranged 8-21 mm (mean 14,3), and the devices 11-30 mm (mean 19,3) were implanted. The procedure and screening time ranged 134-286 (mean 187,2) and 23-90 minutes (mean 43,6) respectively. The successful implantation did not clinically succeed in both patients with the acute septal rupture - they died 2 and 15 days after the procedure. In the eight patients in whom the procedure was performed late (3,5-56 weeks) after the infarction onset, the defect was either completely closed or the shunt was insignificant, and they improved dramatically. In the most recent follow-up from 1 to 62 months (mean 25,5), the patients have been alive and feeling well, and in NYHA I or II class.
CONCLUSION: Primary transcatheter closure of postinfarction ventricular septal defects may be an alternative to surgery in patients with suitable anatomy and completed necrosis. In our experience, primary transcatheter closure of ventricular septal defects in patients who are in the acute phase of infarction does not improve their survival.