膜部室间隔缺损形态、大小与封堵器的选择

Choice of occluder in different shape, size of membranous ventricular septal defect

目的 探讨膜部型室间隔缺损(VSD)各种形态的超声心动图特征,缺损形态、大小与封堵器选择的关系。方法 VSD封堵成功的209例膜部型VSD患者。超声心动图术前测量VSD大小、观察缺损口形态及判断缺损右室侧粘连情况。结果 209例VSD中有184例缺损口呈局限性向右室侧突出,形成不同形态,其中不规则形66 例,漏斗形56 例,瘤形38例,管形24例。不同形态的VSD大小不同,以管形较小,不规则形较大,差异有显著性意义(P<0.05)。184例中有140例呈多孔,平均最大孔径(3.6±1.1)mm。结论 超声心动图在术前准确的测量VSD的大小,观察缺损口形态、缺损右室侧分流口多少及周缘粘连的牢固性等,以筛选VSD封堵术的适应证及合适封堵器大小,保证VSD封堵术的远期疗效。

Objective To research the relationship in echocardiographic characteristics of different shape, size of membranous ventricular septal defect (VSD) with occluder. Methods Two hundred and nine patients with VSD were occluded. Before occlusion, the diameter and type of VSD were measured by echocardiography. Results There were 184 VSDs protruded to right ventricle locally that formed different types in 209 VSDs,including 66 irregular type, 56 infundibulate type, 38 lepromatous type and 24 tuberiform type. The sizes of different type of VSDs were varied ( P <0.05), of which tuberiform type was smaller and irregular type was larger. One hundred and forty membranous VSDs were porosities. The average size of the largest porosity was (3.6±1.1) mm. Conclusion A successful VSD occlusion must depend on the measured VSD size, observed VSD type and number of left to right ventricle shunts accurately.