经胸超声心动图在房间隔缺损介入治疗中的应用

Transthoracic echocardiographic guidance for closure of atrial septnl defects with amplatzer occlusion device

目的 评价经胸超声心动图 (TTE)指导Amplatzer封堵器治疗先天性继发孔型房间隔缺损 (ASD)的作用。方法 3 6例ASD行Amplatzer封堵术的患者 ,年龄 3 -63岁 ,平均 ( 3 1± 14 )岁 ,术前及术中采用TTE指导封堵 ,术后即刻及术后 1个月 ,3个月和 6个月分别行TTE检查评价治疗效果。结果 3 1例 ( 86% )患者术前和术中直接采用TTE指导封堵成功 ,总有效率为 86% ;3例 ( 8% )患者术前加做食管超声 (TEE)选择适应症 ;2例 ( 5 % )患者术中加做TEE指导封堵成功。术中未发生任何重要并发症 ,无急症手术病例。术后即刻TTE彩色多普勒显示 2例 ( 5 % )存在微 /少量残余分流 ,术后 3个月TTE显示 3 6例患者的ASD完全闭合 ,封堵器形态、位置良好 ,未对毗邻结构产生影响 ,且未见封堵器移位及ASD再通。结论 TTE可用于指导大多数ASD患者行经导管Amplatzer封堵器治疗。

Objective To evaluate transthoracie echocardiographic guidance for closure of congenital atrial septal defects with Amplatzer occlusion device.Methods 36 patients with atrial septal defects were occluded by use of Amplatzer septal occluder. The mean age was (31±14) yeare (ranging from 3-63 years).Transthoracic echocardiography was undertaken for guidance for closure before and in the procedure of intervention.Transthoracic echocardiography was done immediately, one month, three month and six month respectively after intevention to evaluate the treatment efficiency. Results 31 patiens were treated successfully directly by guidance of transthoracic echocardiography before the procedure and during the period of closure, the total effectiveness was 86%.three patients needed to have transesophageal echocardiography before closure to select indication and another two patient was treated successfully by adding transesophageal echocardiogeaphy for guidance in the procedure.There was no significant complication that occurred during the procedures, and there was no emergency surgical case.Trivial to small residual shunts were found in 2 cases(5%)immediately after the procedure.No residual shunts were fonud in the three-month follow-up, and all patients had no displacement and recanalizaation in the three-month follow-up.Conclusions Transthoracic echocadiography can guide most of atrial septal defect patients for closure of atrial septal defects with the Amplatzer occlusion device.