经胸超声心动图监测经导管Amplatzer封堵器介入治疗房间隔缺损的临床价值

Clinical value of transthoracic echocardiography in monitoring transcatheter closure of atrial septal defect with Amplatzer occluder

目的探讨经胸超声心动图(Transthoracicechocardiography,TTE)监测经导管引导Amplatzer封堵器介入治疗房间隔缺损(Atrialseptaldefect,ASD)的临床应用价值。方法选择经TTE检查确诊ASD适合做封堵术的9例患者,术前多个切面综合测量ASD的直径,然后在术中监测经导管引导Amplatzer封堵器治疗ASD的全过程,封堵术后即刻、1周内、1个月、3个月、6个月、1a随访TTE,观察封堵效果、封堵器周边有无分流。结果9例ASD患者,除2例因缺损口过大(最大伸展径大于38mm),选用最大的封堵器无效而放弃封堵外,其余7例均成功封堵,术后TTE未见残余分流。结论TTE对ASD封堵术前病例的选择,封堵术中监测及封堵术后疗效评价等均有一定的临床应用价值。

Objective To evaluate transthoracic echocardiography(TTE) in monitoring transcatheter closure of atrial septal defect(ASD) using Amplatzer occluder.Methods Nine patients were diagnosed as having ASD by TTE,of whom seven were treated using Amplatzer occluder.The diameters of ASD were measured by TTE before operation,and the procedure of occlusion was monitored and detected by TTE.so as to ensure that the ASD was occluded firmly.The occluder efficiency was evaluated by TTE immediately,1 week,1 month,3 months,6 months and 1 year after the procedure.The peripheral residual shunts around the occlusion were observed by TTE.Results All 7 patients obtained optimal occlusion of ASD,and no residual shunt was found by TTE immediately.Conclusion TTE is an important technigue for selecting the patients for occlusion of ASD,guiding the device Amplatzer, monitoring the procedure,and evaluating the efficacy after the operation.