经食管超声在室间隔缺损小切口封堵术中的应用

Application of transesophageal echocardiography in device closure of ventricular septal defects with a minimally invasive technique

目的评价TEE在室间隔缺损(VSD)外科小切口封堵术中的价值。方法 25例VSD患者接受外科小切口封堵术,其中膜周型缺损19例,嵴内型缺损6例;缺损直径3～9mm,平均(5.25±3.47)mm。所有患者术前均接受TTE检查评估VSD。气管插管全身麻醉后,在TEE引导下,经右心室游离壁置入VSD封堵器,并于术后即刻评价手术效果。结果 25例均封堵成功,19例使用等边封堵器,6例使用偏心封堵器。25例术后即刻超声及术后超声观察,室间隔水平均无分流信号。结论 TEE在VSD小切口封堵术术中监测及术后评价中具有重要价值。

Objective To assess the value of TEE in device closure of ventricular septal defects（VSD） with minimally invasive perventricular technique.Methods A total of 25 patients with VSD（19 perimembranous VSD and 6 intracristal VSD） underwent TTE for preoperative assessment.The defect diameter ranged from 3 mm to 9 mm with an average value of（5.25±3.47）mm.Under general anesthesia with tracheal intubation,ventricular septal defect occluder was introduced through right ventricular free wall under the guidance of TEE.Results The procedures were successful in all 25 cases.Equilateral occluders were used in 19 and eccentric occluders in 6 cases.No signal of shunt was observed by immediate postoperative TEE.Conclusion TEE has important value in intraoperative monitoring and postoperative evaluation of minimally invasive perventricular approach.