术中复合超声评价先天性心脏病外科矫治术或直视下镶嵌治疗

Utilization of intraoperative complex echocardiography during surgical correction or occlusion of congenital heart disease:Analysis of 218 consecutive studies

目的探讨术中超声心动图在先天性心脏病外科矫治术和非体外循环微创直视下封堵治疗中的应用价值及方法学。方法应用经食管超声心动图(TEE)或心外膜超声心动图(EE)或体表超声心动图(TTE)监测行体外循环下或非体外循环下外科手术的218例先天性心脏病患者。结果在218例患者中,共计实施137例TEE检查、9例EE检查和72例TTE检查,包括室间隔缺损、完全型心内膜垫缺损、主动脉缩窄、大动脉转位等64例先心病的体外循环下外科矫治术,以及154例房间隔缺损和动脉导管未闭的非体外循环下外科封堵术。结论TEE是大多数先天性心脏病外科术中的优选监测技术。EE和TTE则对于非TEE适应证的外科术式或术中紧急情况的评价具有重要价值。

Objective To evaluate the clinical application of combined echocardiography monitoring in cardiac surgery of congenital heart disease. Methods Transesophageal echocardiography （TEE）, epicardial echography （EE） and transthoracic echocardiography（TTE） were used in 218 patients with congenital heart disease during pre - , intra- and immediately post- surgical procedure with pump or without pump. Results All patients underwent cardiosurgery, including 64 cases of surgical correction with extracorporeal circulation, and 154 ASD or PDA cases of off- pump minimally invasive cardiosurgery using Amplatzer occluder. We performed TEE examination in 137 cases, EE in 9 cases and TTE in 72 cases. Conclusion TEE is the preferred examination in most cardiosurgery. EE or TTE is important and irreplaceable in some cases that TEE is unfit for.