Objective To evaluate the interventional therapeutic strategy and effect of one-stage interventional therapy of 109 patients’ with combined congenital heart idsease.
Methods From June 2000 to October 2012, 109 cases with combined congenital heart disease underwent one-stage interventional therapy. There are 38 males and 71 females ranging from 1 to 56 years old (13.8 +/- 14.6). All patients had been diagnosed by X-ray, ECG, echocardiogram, right heart catheterization and cardiac angiography before the interventional therapy. There were 12 cases with Atrial septal defect (ASD) and patent ductus arteriosus (PDA), 39 cases with ASD and pulmonary valvular stenosis (PS), 25 cases with ASD and ventricular septal defect, 1 case with ASD and mitral valve stenosis (MS), 23 cases with VSD and PDA, 8 cases with PDA and PS, 1 case with ASD and PDA and PS. The interventional therapeutic sequence was percutaneous balloon pulmonary valvuloplasty (PBPV) or percutaneous balloon mitral valvuloplasty, VSD closure, PDA closure, ASD closure in turn. And to evaluate the therapeutic effect by echocardiogram, cardiac angiography or cardiac chamber piezometry after procedure immediately. All patients were enforced X-ray, ECG, echocardiogram on 2d, 1, 3 and 6 months after operation for the follow-up.
Results All patients were treated successfully. No complications occurred during the procedure. No residual shunt and dislocation of the devices were found. In the patients with PS, the systolic gradient pressure across the pulmonary valve decreased meet a criterion after operation. In 1 case with ASD and mitral valve, the mitral valve orifice areas increased markably after procedure. During the period of follow-up, the enlarged chambers heart were diminished progressively and all the occluders fixed wel1, X-ray examination showed that pulmonary vascularity diminished significantly, and there was no severe complication in all patients by echocardiogram.
Conclusions Though the operation is more difficult and the interventional technic is more skillful, but multiple transcatheter interventions in the same session are feasible, safe and effective with satisfactory good results. However, a satisfactory result can be obtained from suitable indications by TTE before operation, proper algorithm of procedures and standardised manipulations.