经胸超声心动图在房间隔缺损封堵术中的应用价值

Application value of transthoracic echocardiography in closure of atrial septal defect

目的探讨经胸超声心动图（TTE）在经心导管封堵治疗房间隔缺损（ASD）的应用价值。方法46例ASD患者，缺损口大小6—38mm。所有患者术前均经TTE检查，术中采用TTE监测指导封堵，并于术后随访。结果45例ASD患者在TTE监测指导下封堵成功，1例术中改用经食道超声监测指导封堵成功。术后45例房间隔穿隔血流消失，1例存在4min残余分流束，术后半年复查，残余分流束消失。所有病例封堵器位置固定，无血栓形成，右心有不同程度的缩小。结论TTE对ASD进行封堵术的术前病例筛选，术中实时监测及术后疗效评价有着重要的作用。

Objective To investigate the application value of transthoracic echocardiography in closure of ASD. Methods Forty - six patients with ASD which size ranged from 6 to 38mm were examined by TTE before operation, monitored and guided by TTE during the operation, then followed - up by TTE after the operation. Results Forty- five patients with ASD got successful occlusion by the monitoring and guiding of TTE, 1 patient got successful occlusion by monitoring and guiding of TEE. Examination of TTE after operation showed that shunt flow of 45 ASD disappeared, one still had 4 mm shunt flow, and reexamination showed that the shunt flow disppeared half a year after operation. The position of occluders was normal, no thrombosis and the right heart had different degrees of narrowing. Conclusion TTE plays an important role in screening ASD cases before the occlusion, real - time monitoring during the occlusion, and evaluating effect after occlusion.