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可降解封堵器在室间隔缺损治疗中的应用进展
Application progress on degradable occluder in the treatment of ventricular septal defect

广西医学 页码:791-795

作者机构:陈成,博士,副主任医师,研究方向为儿童心血管疾病。

基金信息:广西西医类别自筹基金资助项目(20210981);广西儿科疾病临床医学研究中心资助项目(桂科AD22035219)

DOI:10.11675/j.issn.0253⁃4304.2025.06.02

  • 中文简介
  • 英文简介
  • 参考文献

在经皮介入治疗方法中,室间隔缺损(VSD)的首选方案是应用封堵器进行治疗。但当前应用的封堵器主要为镍钛合金材质,一旦植入人体后将终生存留体内,由此可能引发机体慢性炎症、心律失常及心脏穿孔等并发症。2022年,全球首款MemoSorb®可降解封堵器获批上市,该产品具有自我降解的特性,一旦植入缺损部位,可转化为二氧化碳、水和乳酸,对人体无害。这种创新的封堵器不仅能够有效避免传统封堵器引发的不良事件及镍过敏问题,而且不会对后续介入治疗产生负面影响,实现了“无植入”介入治疗的目标。然而,目前可降解封堵器在X射线下显影性不足,需依赖辅助成像系统并结合术者操作经验实现精准定位。在未来可通过材料工程改良、器械结构优化及操作流程标准化,从而增强可降解封堵器的安全性和治疗效能。

In the method of percutaneous interventional therapy, the preferred regimen for ventricular septal defect (VSD) is the use of an occluder. However, most currently available occluders are made of nickel⁃titanium alloy materials, which remains permanently in the body after implantation. This may lead to complications such as chronic inflammation, arrhythmias, and cardiac perforation. In 2022, the world's first MemoSorb® degradable occluder was approved for clinical use. This device features self⁃degrading properties—once implanted at the defect site, it gradually breaks down into carbon dioxide, water, and lactic acid, all of which are harmless to the human body. This innovative occluder not only effectively avoids adverse events associated with traditional occluders (including nickel allergy) but also eliminates interference with subsequent interventional therapy, achieving the goal of "implant⁃free" interventional therapy. However, current degradable occluders have limited visibility via X⁃ray imaging, requiring reliance on auxiliary imaging systems and the operator's experience for precise positioning. Future improvements such as material engineering enhancements, structural optimization of the device, and standardized procedural protocols could further enhance the safety and therapeutic efficiency of degradable occluders.

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