Although most of the atrial septal defect can be cured by occlusion, but the use of nitinol occluder made after implantation of foreign body reaction and other complications may occur, in addition, a permanent metal occluder blocked atrial septal pathways, making the future can not be some intervention such as radiofrequency ablation of atrial fibrillation and percutaneous balloon mitral valvuloplasty and so on.
With the continuous introduction of new equipment and operation of technology maturity, congenital heart disease intervention a qualitative change in a variety of new interventional treatments have been developed, intervention attitudes are updated, resulting in the emergence of many new trends in the field.
implanted stents can "grow up"
coarctation of the aorta (CoA) past require surgery, but a higher mortality and complication rate. With the advent of balloon and stent, coa by balloon angioplasty and stenting to cure, even if the patent ductus arteriosus combined coa can also be coated stent implantation through a simple one-time solution. Currently, coa can be narrowed according to age and anatomical characteristics taken at a variety of interventional treatment: patients for infants and young children can be treated by balloon angioplasty alleviate the condition, children had to be re-growth period after stent implantation; For older patients, regardless of whether the merger patent ductus arteriosus, if there is hypoplastic aortic arch and descending aorta dilated, both stent implantation can be completely cured, and for the descending aorta in patients with dilated, you can bare stent implantation to obtain cure. In addition, coarctation of the aorta stent also can double or multiple expansion, that is, after stent implantation in patients with age in patients with aortic lumen widened, the implanted stent diameter stenosis appear, but also by balloon expansion of the stent diameter to widen again.
atrial septal defect can be "slow" fill
atrial septal defect (ASD) is one of common congenital heart disease In the past, when the ASD with severe pulmonary hypertension (pulmonary artery systolic pressure ≥ 60mmHg) when the patient loses surgical treatment. In addition, a large number of large ASD due to the long left-right shunt, leading to right heart enlargement and left ventricular system in the state of disuse, once implemented, block or repair, the patient is prone to left ventricular failure and arrhythmia, and even fatal pulmonary edema. The hole can pass ASD occluder left atrial pressure, does not result in a sudden significant increase in left atrial pressure, while a modest increase in left ventricular volume, the left ventricular myocardium gradually training. So, not only effectively reduce the left-right shunt, pulmonary artery pressure to prevent the further development, while improving left ventricular function and prevent left ventricular dysfunction occurs. General Hospital of Shenyang Military Region, since 2002, the seven ASD with severe pulmonary hypertension in patients with perforated ASD occluder, which have received good effect, the longest follow-up of more than 5 years, all patients were significantly improved heart function, pulmonary artery pressure decreased in varying degrees, left ventricular dysfunction does not appear the performance.
RF current is a frequency of about 500kHz AC current, this current can produce a variety of biological effects, will not have adverse nerve and muscle tissue stimulation. 1993, Hausdorf and so this technology for muscular infundibular punch, so that between the right ventricle and pulmonary artery traffic, but until the last two years, the technology only in the country began to use, the application of the most successful treatment of intact ventricular septum pulmonary atresia. Of pulmonary atresia with intact ventricular septum is a natural outcome of poor cyanotic congenital heart disease, even surgery, postoperative mortality rate as high as 52% within one year, and survival of patients required a second line of the right ventricular decompression surgery. RF punch in the treatment of pulmonary atresia with intact ventricular septum is not only a very small wound, and safer than surgery. In addition, radio frequency technology in the drilling of the mosaic treatment of complex congenital heart disease also has broad application prospects.
Although most of the atrial septal defect can be cured by occlusion, but the use of nitinol occluder made after implantation of foreign body reaction and other complications may occur, in addition, permanently blocking the metal occluder septal diameter Road, making the future can not be some intervention, such as atrial fibrillation radiofrequency ablation and percutaneous balloon mitral valvuloplasty and so on. Currently, a foreign invention can be absorbed occluder (BioSTAR). This double umbrella occluder to porcine small intestine by a layer of collagen matrix covered in a special bracket made. This material has been reported with atrial septal defect occluder for 58 cases of atrial septal defect and patent foramen ovale closure therapy, only five patients had a short residual shunt. Although currently only available for absorption occluder atrial septal defect and patent foramen ovale of the intervention, and the closure of the defect is not large, but in the treatment of congenital heart disease, interventional closure milestone. With the maturity of production technology, I believe that will create greater resistance occluder, which for ventricular septal defect and patent ductus arteriosus and other interventional treatment of disease, and eventually replace the metal occluder.
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