经胸超声心动图监测引导经导管房间隔缺损封堵术的临床研究

The clinical studies of transthoracic echocardiographic guidance in transcatheter closure of secundum atrial septal defect

目的 探讨经胸超声心动图 (TTE)监测引导经导管封堵房间隔缺损的可行性。方法 2 5例确诊为二孔房间隔缺损患者 ,男 11例 ,女 14例。所有病例均使用Amplatzer封堵伞 ,TTE术前筛选病例 ,封堵术中TTE全程监测引导 ,术后即刻、2 4h、1个月、3个月复查评价并同时拍片或录像进一步分析。结果 TTE测量缺损最大径为 4～ 2 5mm[( 13 .2 8± 5 .78)mm] ,封堵伞型号 10～ 2 8mm [( 16 .92± 5 .6 6 )mm ] ,二者直线相关方程Y =0 .9395X +4.443 7,相关系数r =0 .95 96 ,P <0 .0 1。所有病例均封堵成功 ,技术成功率 10 0 % ,术后 3个月复查房水平分流完全消失。结论 TTE是监测引导房间隔缺损封堵治疗的较好方法 ,是完全可行的 。

Objective To explore the feasibility of transthoracic echocardiographic(TTE) guidance in transcatheter closure of secundum atrial septal defect(ASD).Methods Twenty five patients with secundum ASD (male 11,female 14) were implanted Amplatzer occluder device.TTE study was performed before the intervention therapy in order to appreciate these cases.The closure of ASD was monitored and guided with TTE throughout the procedure. Immediate evaluation was carried out with 24h,1 month,3 month follow up.Results The maximal diameter of the ASD was 4～25 mm[( 13.28 ± 5.78 )mm],the diameter of the Amplatzer occluder selected was 10～28 mm[( 16.92 ± 5.66 )mm],the maximal diameter of ASD measured by TTE correlates well with the Amplatzer occluder selected(Y= 0.939 5 X+ 4.443 7 ,r= 0.959 6 ,P< 0.01 ).All the ASD occlusions were successful.There was no residul shunt with 3 month follow up.Conclusions TTE guidance in transcatheter closure of ASD is an optimal imaging technique.