#临床研究#TransientST2segment2elevationduringtranscatheterclosureofatrialseptaldefect(ASD)withASDoccludermadeinChina:AreportoftwocasesWANGXian,HUDa2yi,SUNQi,TANChen(DepartmentofCardiology,BeijingMilitaryGeneralHospita,lBeijing100700,China)Abstract:AIMThesafetyandefficacyofatrialseptaldefect(ASD)occluder(ASDO)madeinChinafortranscatheterclosureofASDhaveinvestigatedprospectively.WereportthephenomenonoftransientST2segment2elevation(TSTE)duringtranscatheterclosureofASDwithASDOmadeinChinainthissingle2centrestudy.METHODSAtotalof35consecutivepatientsinwhomaseptaldefectoccluder(HuayishengjieInc.,Beijing,China)wasusedtocloseaclinicallysignificantASDwereincludedinourstudy.Allproceduresperformedunderbasicorlocalanaesthesiawithtransthoracicechocardio2graphicguidance.Interatrialcommunicationswereassessedbytransthoracicechocardiography(TTE)withreferencetosize,positionintheinteratrialseptum,proximitytosurroundingstructures,andadequacyofseptalrim.Deviceselectionwasbasedonandmatchedtothestretcheddiameterofthecommunication.Successdefinedasdeploymentofdeviceinastablepositiontooccludetheinteratrialcommunicationwithoutinducingfunctionalabnormalityoranatomicalobstruction.Occlu2sionstatusdeterminedbyTTEduringprocedureandthefollowupofthestudyat3,6,and12months.RESULTSIn2ofthe35patientsfromourcentre,atransientST2segment2elevationgreaterthan0.2mVwasrecordedandanginapectorisoccurredduringthedeploymentofthedevice.TheECGchangesandthesymptomsstartedabruptlyandlastedfor(412?212)min.AlltheECGchangesoccurredinleadII,III,andaVF.Theassociationbetweentheheartrate,bloodpressureandtheECGchangeswasdescribed.ThebradycardiaandhypotensionwereseenduringST2segment2elevationinthesetwopatients.Theadministrationofintravenousnitroglycerinwasperformed,thesymptomsandECGchangesdidn.trecoveredimmediately.Whenthedeviceswereretrievedbywithdrawingitintothesheathbytractiononthedeliverywire,thesymp2tomsweregraduallyeliminatedandECGchangesrecuperatedimmediately.NohaemodynamicderangementortransientECGchangesoccurredafterthelargerdiameterdeviceswereexchanged.Duringthefollow2upofthestudyat3,6,and12monthsthesetwopatientsshowednofurthersignsofmyocardialischemiaandwerefreeofepisodesofanginapectoris.CONCLUSIONThephenomenonofST2segment2elevationduringtranscatheterclosureofASDmaybecausedbythemechanicaleffectsofthelargerdiameterASDO.Keywords:atrialseptadefect;atrialseptadefectoccluder;transientST2segment2elevation基金项目:国家卫生部/十年百项0推广项目基金资助(200713)通讯作者:王显,主任医师,主要从事介入心脏病学、预防心脏病学和中西医结合心脏病学研究Emai:lWX0515@hotmai.lcom国产封堵器闭合房间隔缺损过程中的短暂ST段抬高2例王显,胡大一,孙琪,谭琛(北京军区总医院心血管内科,北京100700)摘要:目的国产房间隔封堵器闭合房间隔缺损的安全性和有效性已得到证实。我们报告在使用国产封堵器闭合房间隔缺损过程中出现的短暂ST段抬高现象2例。方法适合进行经皮封堵术的房间隔缺损患者35例,使用北京华医圣杰公司生产的房间隔封堵器进行封堵。术前经胸超声充分评估缺损的大小、位置、与周围结构的距离以及房间隔的软硬边缘等,选择封堵器要与缺损的伸展直径相匹配。手术过程在局部麻醉或者基础麻醉下进行,术中使用经胸超声引导。封堵器释放后有效闭合缺损、位置稳定且不影响周边结构视为手术成功。术后3,6,12月进行随访。结果在35例患者中有2例在封堵器释放过程中,出现短暂性ST段抬高超过2mV,伴有心绞痛发作。心电图改变和症状发作平均持续时间(4.2?2.2)min,2例心电图改变均发生于II,III和aVF导联,此过程伴有心率减慢和血压降低...
