房间隔缺损介入封堵后心脏结构变化的研究

Research on the Changes of Cardiac Geometry after Transcatheter Closure of Atrial Septal Defect

目的:探讨房间隔缺损(ASD)封堵术后心脏结构改变及其临床价值。方法:成功实施经封堵器封堵ASD的74例患者在封堵术前、术后3 d、3个月及6个月时行经胸超声心动图检查,测量相关指标:左室舒张末期内径(LVEDD)、右心室收缩末期容量(RVEDD)、左房内径(LAD)、右房长径(RAD1)和右房横径(RAD2)。并将这74例患者在术前、术后及随访过程中所测得的指标作对照研究。结果:ASD封堵术后3 d及术后3个月,RVEDD、RAD1和RAD2逐渐缩小,LVEDD和LAD逐渐增大。术后6个月随访时,各指标无进一步改变。结论:ASD封堵术治疗既减轻了右心容量负荷,使右房、右室内径缩小,也改善了左心的几何构型,使已经缩小的左房、左室逐渐增大恢复。

Objective： To discuss the changes of cardiac morphology and clinical evaluation after ASD operation. Methods： The left ventricular end - diastolic diameter（LVEDD）, the tight ventricular end - diastolic di- ameter（RVEDD）, left arterial diameter （LAD）right atrial long diameter （RAD1）, tight arterial transverse diam- eter （RAD2） in 74 patients are measured before closure, after 3 days, 3 months, 6months of ASD closure with transthoracic echocardiography. A control study on various index of preoperation, postoperation, follow up pro- eel. Results：RVEDD, RAol AND RAD2 decrease, while LVEDD and LAD increase after ASD closure. All pa- rameters has no difference between 6 months and 3 months follow up. Conclusion： Closure of ASD not only de- creases the preload of right heart, improves the geometry of left heart, but also the left arterial and ventricular returns to normal status.