梗死后室间隔缺损介入封堵：现有证据的系统综述
Interventional post-myocardial infarction ventricular septal defect closure: a systematic review of current evidence
梗死后室间隔缺损（VSD）的介入封堵是外科修补之外的替代方案，但证据有限。本系统综述纳入13个系列、共273例患者，平均年龄70岁，48%在介入时存在心源性休克。技术成功率超过75%，装置植入成功率89%，住院/30天死亡率32%，主要并发症包括装置栓塞、心室穿孔和心律失常。结论认为介入封堵是可行的替代方案，但死亡率仍高，尤其在心源性休克患者中。
为什么推荐给您：对已有介入封堵证据的系统汇总，属常规证据整合，无新方法或新发现。
不需要生物学背景，多打比方
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摘要Abstract
AIMS: Interventional closure of post-myocardial infarction ventricular septal defects (VSD) is an alternative treatment option to surgical repair. However, only limited evidence exists concerning the interventional closure of a VSD. This review seeks to establish an overview of the existing literature and to carry out a systematic analysis of the success rate and clinical outcome of this procedure.
METHODS AND RESULTS: We conducted a comprehensive systematic literature search to evaluate the existing evidence of percutaneous device closure of post-infarction VSD. Patient series with fewer than five reported cases were excluded. In total, 13 series were identified, with an overall inclusion of 273 patients. Mean patient age was 70 years. Cardiogenic shock was present in 48% of cases at the time of intervention. Device closure within the first 14 days (acute phase) after VSD detection was performed in 42% of cases. Technical success rate was high (>75%). Successful device implantation rate was 89%. Overall in-hospital/30-day mortality was 32%. Major complications included device embolisation, ventricular perfora-tion and arrhythmias.
CONCLUSIONS: Percutaneous device closure of post-myocardial infarction VSD is a valuable alternative to surgical repair, with the advantage of immediate shunt reduction to prevent haemodynamic deterioration. A high rate of technically successful percutaneous procedures can be achieved; however, the mortality rate remains high, especially in cardiogenic shock patients.