经胸超声心动图预测房间隔缺损封堵器直径

Estimation of the Diameter of Occluder Device for the Closure of Atrial Septal Defect by Transthoracic Echocardiography

目的:探讨经胸超声心动图(TTE)预测房间隔缺损(ASD)封堵器直径的价值。方法:使用VIVID 7超声仪分别在主动脉根部短轴切面、胸骨旁四腔心切面及剑突下两心房切面测量ASD直径,房间隔总长度及残余房间隔各硬缘长度。预选封堵器直径为测得的最大ASD直径加4 mm。在X线透视和TTE监测下行ASD封堵术。结果:14例ASD手术当日TTE测量缺损最大径为17～31 mm,术中所用封堵器直径为22～40 mm,二者间相关性良好(r=0.91)。除两例术中试用不同型号封堵器外,其余均以TTE测得的最大ASD直径加4 mm选用封堵器型号,一次成功。结论:TTE能准确预测ASD封堵器型号,从而大大节省手术操作时间。

Objective：To assess the value of transthoracic echocardiography （TTE） in predicting the diameter of the occluder device for the closure of atrial septal defect （ASD）. Methods：TTE was performed with a VIVID 7 ultrasonography equipment to determine the largest diameter of ASD,the total length of intra atrial septum,and the length of residual solid edge of ASD respectively at the short axis plane of the aortic root,the parasternal four chamber plane,and the subxiphoid plane of the two atriums. The diameter of the selected occluder was based on the measured largest ASD diameter plus 4mm. ASD closure procedure was guided under fluoroscopy and TTE. Results： Altogether there were 14 patients,the largest ASD diameter measured was 17-31mm,and the diameter of occluder used was 22-40mm with a good correlation of the two （r=0.91）. Apart from two patients for whom a different size occluder had been chosen,all the other patients were treated successfully at the first try with the occluder that had been added by the 4mm to the largest diameter of ASD measured hy TTE. Conclusion：The size of the occluder for the closure of ASD could be accurately predicted by TTE,thus the time of the interventional operation could be enormously saved.