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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/94738完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 林銘泰 | zh_TW |
| dc.contributor.advisor | Ming-Tai Lin | en |
| dc.contributor.author | 秦家翊 | zh_TW |
| dc.contributor.author | Chia-Yi Chin | en |
| dc.date.accessioned | 2024-08-16T17:54:28Z | - |
| dc.date.available | 2024-08-17 | - |
| dc.date.copyright | 2024-08-16 | - |
| dc.date.issued | 2024 | - |
| dc.date.submitted | 2024-06-17 | - |
| dc.identifier.citation | 1. Wu M-H, Chen H-C, Lu C-W, Wang J-K, Huang S-C, Huang S-K. Prevalence of congenital heart disease at live birth in Taiwan. The Journal of pediatrics. 2010;156(5):782-785.
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Journal of the American Society of Echocardiography. 2003;16(7):777-802. 15. Ohuchi H, Kawata M, Uemura H, Akagi T, Yao A, Senzaki H, et al. JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair. Circulation Journal. 2022;86(10):1591-1690. 16. Jiang D, Han B, Zhao L, Yi Y, Zhang J, Fan Y, et al. Transcatheter Device Closure of Perimembranous and Intracristal Ventricular Septal Defects in Children: Medium- and Long-Term Results. J Am Heart Assoc. 2021;10(11):e020417. 17. Tatsuno K, Konno S, Ando M, Sakakibara S. Pathogenetic mechanisms of prolapsing aortic valve and aortic regurgitation associated with ventricular septal defect: anatomical, angiographic, and surgical considerations. Circulation. 1973;48(5):1028-1037. 18. Chiu SN, Wang JK, Lin MT, Chen CA, Chen HC, Chang CI, et al. Progression of aortic regurgitation after surgical repair of outlet-type ventricular septal defects. Am Heart J. 2007;153(2):336-342. 19. Butera G, Carminati M, Chessa M, Piazza L, Micheletti A, Negura DG, et al. Transcatheter closure of perimembranous ventricular septal defects: early and long-term results. J Am Coll Cardiol. 2007;50(12):1189-1195. 20. Lee SM, Song JY, Choi JY, Lee SY, Paik JS, Chang SI, et al. Transcatheter closure of perimembranous ventricular septal defect using Amplatzer ductal occluder. Catheterization and Cardiovascular Interventions. 2013;82(7):1141-1146. 21. Tzikas A, Ibrahim R, Velasco‐Sanchez D, Freixa X, Alburquenque M, Khairy P, et al. Transcatheter closure of perimembranous ventricular septal defect with the Amplatzer® membranous VSD occluder 2: Initial world experience and one‐year follow‐up. Catheterization and Cardiovascular Interventions. 2014;83(4):571-580. 22. Yang J, Yang L, Yu S, Liu J, Zuo J, Chen W, et al. Transcatheter versus surgical closure of perimembranous ventricular septal defects in children: a randomized controlled trial. Journal of the American College of Cardiology. 2014;63(12):1159-1168. 23. Otterstad J, Simonsen S, Erikssen J. Hemodynamic findings at rest and during mild supine exercise in adults with isolated, uncomplicated ventricular septal defects. Circulation. 1985;71(4):650-662. 24. Jablonsky G, Hilton JD, Liu PP, Morch JE, Druck MN, Bar-Shlomo B-Z, et al. Rest and exercise ventricular function in adults with congenital ventricular septal defects. The American Journal of Cardiology. 1983;51(2):293-298. 25. Somerville J. Congenital heart disease--changes in form and function. British Heart Journal. 1979;41(1):1. | - |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/94738 | - |
| dc.description.abstract | 背景：
罹患膜邊型心室中膈缺損（pmVSD）的病人，在接受經心導管關閉術而引起的併發症，如殘餘分流和主動脈逆流（AR），近年已陸續有許多研究觀察到。然而，目前尚不清楚與之相關的風險因素，特別是在兒童族群。本研究目的在於尋找2至12歲的年幼兒童之pmVSD經心導管關閉後殘餘分流和AR的相關風險因素。 方法和結果： 我們分析了在台大兒童醫院小兒心臟科，於2011年至2018年間接受經心導管關閉術的63名pmVSD兒童，其肺循環至全身循環血流比率低於2.0的醫療記錄，並進行了至少3年的追蹤。所有接受經心導管關閉術治療的兒童的成功率為98.4％，並無主要嚴重的併發症產生，例如緊急外科手術、永久性高度房室傳導阻滯或死亡。在殘餘分流的部分，心室中膈缺損若大於4.5mm則具有顯著較高的持續性殘餘分流風險（勝算比：6.85，p = 0.03）。使用比缺損直徑大1.5mm的關閉器尺寸顯示出減少殘餘分流的趨勢（勝算比：0.23，p = 0.06）。而年齡小於4歲（勝算比：27.38，95％CI：2.33–321.68）和出口型pmVSD（勝算比：11.94，95％CI：1.10–129.81）是關閉pmVSD後AR惡化的獨立風險因素。 結論： 對於超過4.5mm的pmVSD，需要特別注意追蹤經心導管關閉後的持續性殘餘分流。在考慮pmVSD關閉的好處時，仔細評估AR風險，特別是對於4歲以下兒童以及pmVSD分類，是至關重要的。 | zh_TW |
| dc.description.abstract | Background
Complications arising from transcatheter closure of perimembranous ventricular septal defects (pmVSD) in children, such as residual shunts and aortic regurgitations (AR), have been observed. However, understanding the associated risk factors remains unclear. This study aims to identify risk factors linked with residual shunts and AR following transcatheter closure of pmVSD in children aged 2–12 years. Methods and Results Medical records of 63 children with pmVSD and a pulmonary-to-systemic blood flow ratio below 2.0 who underwent transcatheter closure between 2011 and 2018 in National Taiwan University Children Hospital were analyzed with a minimum 3-year follow-up. The success rate of transcatheter closure was 98.4%, with no emergent surgery, permanent high-degree atrioventricular block, or mortality. Defects exceeding 4.5 mm in diameter had significantly higher odds of persistent residual shunt (OR: 6.85, p = 0.03). The use of an oversize device (>1.5 mm) showed a trend toward reducing residual shunts (OR: 0.23, p = 0.06). Age under 4 years (OR: 27.38, 95% CI: 2.33–321.68) and perimembranous outlet type VSD (OR: 11.94, 95% CI: 1.10–129.81) were independent risk factors for AR progression post-closure. Conclusion Careful attention is crucial for pmVSDs larger than 4.5 mm to prevent persistent residual shunts in transcatheter closure. Assessing AR risk, particularly in children under 4 years old, is essential while considering the benefits of pmVSD closure. | en |
| dc.description.provenance | Submitted by admin ntu (admin@lib.ntu.edu.tw) on 2024-08-16T17:54:27Z No. of bitstreams: 0 | en |
| dc.description.provenance | Made available in DSpace on 2024-08-16T17:54:28Z (GMT). No. of bitstreams: 0 | en |
| dc.description.tableofcontents | 目 次
謝辭 i 中文摘要 ii 英文摘要 iii 目次 v 圖次 vii 表次 viii 英文縮寫對照表 ix 正文 第一章 Introduction 1 1.1 Epidemiology of ventricular septal defect 1 1.2 Managing perimembranous ventricular septal defects 2 第二章 Method 4 2.1 Patients 4 2.2 Cardiac catheterization protocol 6 2.3 TTE follow-up 7 2.4 Statistical analysis 8 第三章 Results 10 3.1 General characteristics and interventional data 10 3.2 Early complications 13 3.3 Post-intervention follow-up 14 3.4 Residual shunts 14 3.5 Aortic Regurgitation 23 3.6 Changes in left ventricular volume after transcatheter closure 28 第四章 Discussion 31 第五章 Conclusion 36 參考文獻 37 附錄 42 | - |
| dc.language.iso | en | - |
| dc.subject | 心室中膈缺損 | zh_TW |
| dc.subject | 經心導管關閉術 | zh_TW |
| dc.subject | 年幼兒童 | zh_TW |
| dc.subject | 殘餘分流 | zh_TW |
| dc.subject | 主動脈逆流 | zh_TW |
| dc.subject | Residual shunt | en |
| dc.subject | Ventricular septal defect | en |
| dc.subject | Transcatheter closure | en |
| dc.subject | Young children | en |
| dc.subject | Aortic regurgitation | en |
| dc.title | 年幼兒童經心導管關閉膜邊型心室中膈缺損後長期後遺症的風險因素 | zh_TW |
| dc.title | Risk Factors of Long-term Sequelae after Transcatheter Closure of Perimembranous Ventricular Septal Defect in Young Children | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 112-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 邱舜南;楊鎧鍵 | zh_TW |
| dc.contributor.oralexamcommittee | Shuenn-Nan Chiu;Kai-Chien Yang | en |
| dc.subject.keyword | 心室中膈缺損,經心導管關閉術,年幼兒童,殘餘分流,主動脈逆流, | zh_TW |
| dc.subject.keyword | Ventricular septal defect,Transcatheter closure,Young children,Residual shunt,Aortic regurgitation, | en |
| dc.relation.page | 43 | - |
| dc.identifier.doi | 10.6342/NTU202401184 | - |
| dc.rights.note | 同意授權(全球公開) | - |
| dc.date.accepted | 2024-06-18 | - |
| dc.contributor.author-college | 醫學院 | - |
| dc.contributor.author-dept | 臨床醫學研究所 | - |
| 顯示於系所單位： | 臨床醫學研究所 | |
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