超声心动图在房、室间隔缺损围封堵术中的应用价值

Value of Echocardiography for Transcatheter Closure of Atrial Septal Defect and Ventricular Septal Defect

目的 评价超声心动图在经心导管房、室间隔缺损围封堵术的应用价值。方法 79例房间隔缺损(ASD)、6例膜部室间隔缺损(VSD)患者在经食管或经胸超声心动图(TTE、TEE)监测下,经心导管行房、室间隔缺损围封堵术。结果 ASD有73例封堵成功,超声检测缺损大小和球囊注水测值相关良好(26.1±7.4)mm和(26.3±6.4)mm,r=0.94,P<0.001。6例VSD超声测量大小为(4.9±1.3)mm(4～6mm),选用(6.3±1.3)mm(4～8 mm)的封堵器全部获得成功。结论 超声心动图(TTE和TEE)利于术前病例选择、术中闭合器放置指导和术后疗效评价以及随访有无残余分流,是该手术不可缺少的监测手段。超声监测途径的选择可根据具体情况而定,当缺损过大,边缘短小或缺如以及TTE成像不满意时宜行TEE监测。

Purpose: To assess the value of echocardiography in transcatheter closure of atrial septal defect(ASD) and ventricular septal defect(VSD). Methods: Seventy-nine patients with ASD and 6 patients with perimembranoys VSD underwent transcatheter closure under the guidance of transthoracic (TTE) and/or transesophageal (TEE) echocardiography. Results: Seventy-three patients with ASD had a succeseful operation. The ASD size measured by echocardiography was correlated with that by the ballon[(26.1 ± 7.4)mm vs (26.3 ± 6.4)mm, r = 0.94, P &le 0.001]. All of the 6 patients with VSD had a succeseful operation. The VSD size measured by echocardiograpy was(4.9 ± 1.3)mm (4-6 mm), the occluder sizes were(6.3 ± 1.3)mm (4-8 mm). Conclusions: Echocardiography(TEE and TTE) was valuable for selecting patients, guiding the transcather closure procedure, assessing the efficacy and detecting the residual shunting during and after the operation. Large ASD, ASD with short edges, and with suboptimal TTE imaging should be monitored by TEE during the operatin.