超声心动图在经导管封堵主动脉窦瘤破裂中的应用价值

Value of echocardiography in transcatheter closure of ruptured sinus of Valsalva aneurysm

目的探讨超声心动图评价经导管封堵主动脉窦瘤破裂疗效的应用价值。方法对11例行经导管封堵主动脉窦瘤破裂患者的超声心动图进行回顾分析。评价术前窦瘤破口的位置、形态、大小等，术中监测封堵器置入，术后随访评价其疗效。结果11例患者术前超声诊断均为单纯主动脉窦瘤破裂，超声测得破口直径2～13mm。11例患者均封堵成功，10例采用动脉导管封堵器，型号较破口直径大约1～5mm。3例患者术后即刻少量残余分流于术后1月内复查消失，其中1例患者术后32月随访时再次出现少量残余分流；所有患者未见主动脉瓣反流加重等并发症。结论经导管封堵主动脉窦瘤破裂是治疗主动脉窦瘤破裂安全有效的方法，远期疗效需进一步观察，超声心动图在其中发挥重要作用。

Objective To evaluate the value of echocardiography in transcatheter closure of ruptured sinus of Valsalva aneurysm（TC-RSVA）. Methods TC-RSVA was attempted in 11 patients. The location, shape,size of defects and its relationship with the neighbor structures were revealed before the procedure. Then the deployment of occluder was monitored during the procedure,and the effectiveness was observed in the follow-up. Results Eleven patients were diagnosed as the isolated RSVA by echocardiography. The size of defects was 2 - 13 mm estimated by echo. The procedures were successful in all patients. Usually the Amplatzer duct occluders were chosen to be 1 to 5 mm larger than the size of defects. Three patients had mild residual shunt during the procedure, which all dispeared in the first month of follow-up, but one of them demonstrated recurrent mild residual shunt in the 32nd month of follow-up. There was no aggravating aortic regurgitation in the follow-up. Conclusions TC-RSVA is relatively safe and effective. Observation of long-term effectiveness is still necessary. Echocardiagraphy plays an important role in TC-RSVA.