Evaluation of interventional therapy in the combined congenital heart diseases:analysis of 57 cases

Objective:To evaluate the efficacy of interventional therapy for the combined congenital heart diseases (CHD). Method:Transcatheter closures were performed in 57 patients with the combined defects in this!study, including 21 patients with perimembranous ventricular septal defect (VSD) and atrial septal defect (ASD), 4 patients with VSD and ductus arteriosus(PDA), 8 patients with ASD and PDA, 22 patients with ASD and pulmonary stenosis (PS) and 2 patients with VSD and PS. The sequence of interventional therapy for the complex malformations was in order of PS, VSD, PDA and ASD. Result:Without severe complications, 56 patients were treated successfully except one patient with VSD and PDA. We only closed his VSD successfully and gave up closing the PDA because the diameter of PDA is too small to let the wire get through. The results of the left ventricular angiography and transthoracic echocardiography (TTE) that performed fifteen minutes after the procedure showed that there was no residual shunt flow in the patients with VSD, ASD and PDA and the occluders fixed well. In the 24 patients complicated with PS, the systolic pressure gradient across the pulmonary valve decreased from (96.0±30.0) mmHg (1mmHg=0.133 kPa) to (15.6±3.3 )mmHg and the difference was significant (P0.01). The TTE, electrocardiography and fluoroscopy were scheduled before and at 1,6 and 12 months after discharge for the followup. All of the patients had no residual shunt flow, all the occluders fixed well, the systolic pressure gradient across the pulmonary valve were all in the normal range and there was no complication during the follow up in all patients.Conclusion:Interventional therapy is safe and effective in patient with combined congential neart diseases than that of the single lesims.