经食管超声心动图在经胸微创房间隔和室间隔缺损封堵术中的应用

Application of transesophageai echocardiography on minimally invasive surgical closure of atrial and ventricular septai defects

目的探讨经食管超声心动图（TEE）在经胸微创房、室间隔缺损封堵治疗中的应用价值。方法经胸超声心动图（TTE）粗筛34例房间隔缺损（AsD）患者和38例室间隔缺损（VsD）患者，拟行经胸微创封堵治疗。术中行TEE根据缺损位置、类型、大小选择合适的封堵器；引导封堵器放置，评价即刻封堵效果；术后1周内复查。结果32例ASD和29例VSD患者封堵成功。术后1周内超声随访，封堵器位置均正常，3例ASD患者微量残余分流，患者心室重构改善，瓣膜反流程度减轻，肺动脉压力下降。结论TEE对选择适合行经胸微创封堵的ASD、VSD患者、选择合适的封堵器、协助封堵器的释放、评价疗效均有重要的作用。经胸微创封堵ASD、VSD安全、有效。

Objective To evaluate the clinical value of transesophageal echocardiography （TEE） on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect （ASD） and 38 patients with ventricular septal defect （VSD） were selected by transthoracic echocardiography （TTE） prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On I week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventricular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defect,s, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.