肌部室间隔缺损封堵剖析

Analyzation of the occlusion of muscular ventricular septal defect

目的:探讨肌部室间隔缺损封堵的超声心动图筛选适应证及价值。方法:应用HPsonos1500和5500彩色超声诊断仪检查12例拟行封堵术的患者,观测左右室侧缺损口大小、缺损残端距主动脉瓣和三尖瓣的距离。结果:9例封堵成功,左右室侧缺损口大小差异显著,分别为8.5±2.6(6.0～14.0)mm及6.1±1.2(4.0～7.0)mm,残端距主动脉右瓣距离6.0～13.0mm,距三尖瓣7.0～15.0mm,室缺多位于室间隔中部或调节束上方。3例封堵不成功,2例室缺口较大且左右室面大小相同,位于右室流入道部,放置封堵器时因出现Ⅲ度房室传导阻滞而放弃。另1例右室侧缺损口过小,造成穿隔失败。结论:用超声心动图筛选适应证对肌部室间隔缺损封堵成功与否有重要的作用。

AIM:To explore the value and the indications of echocardiography in closing the muscular ventricular septal defect(MVSD). METHODS: 12 patients who would be carried out to close MVSD with occluder were examined by HP sonos 1500 and 5500 color Doppler echo machines. MVSD sizes, distance from MVSD to aortic valve and tricuspid valve were measured. RESULTS: MVSD was occluded successfully in 9 cases, There was difference of the sizes of MVSD from left and right ventricle, 8.5±2.6(6.0~14.0)mm and 6.1±1.2(4.0~7.0)mm respectively. The distance between MVSD to aortic right valve and to tricuspid valve were 6.0~13.0 mm and 7.0~15.0 mm separately. Most MVSD lay on the midseptum or up to moderator band of right ventricle. The shunt from left ventricle to right ventricle was showed by color Doppler flow imaging. 2 cases, whose size of MVSD was big and the same on left and right ventricle viewed, occurred III°atrioventricular block and failed to occlusion MVSD. CONCLUSION: The indications of echocardiography is important in close MVSD.