超声心动图在介入封堵房缺术中的应用

Application of Echocardiography in Transcatheter Occlusion of Atrial Septal Defect

目的：评价经胸超声心动图（TTE）与经食管超声心动图（TEE）在继发孔型房间隔缺损（ASD）介入封堵术中的应用价值。方法：对52例继发孔型ASD患者术前均行TTE或TEE检查,根据检查结果选择封堵器型号,术中应用TTE或TEE引导监测封堵器的释放。根据引导方式,分为A组30例,使用TTE引导监测;B组22例,使用TEE引导监测。术后使用TTE随访。结果：A组29例在TTE引导下介入封堵治疗成功,1例因下腔静脉缘较薄未封堵成功,成功率96.67%;B组21例在TEE引导下介入封堵治疗成功,1例因ASD过大未封堵成功,成功率95.45%。A组TTE术前检查ASD直径3~27mm,实际用封堵器大小8~36mm,B组TEE术前检查ASD直径4~36mm,实际用封堵器大小8~40mm,A组ASD直径小于B组,两组差异无统计学意义（P〉0.05）;A组封堵器大小小于B组,两组差异无统计学意义（P〉0.05）;两组ASD直径与封堵器大小间相关性均较好。50例随访3~6个月以上,效果良好,均无并发症。结论：依靠TTE或TEE选择封堵器、术中引导监测ASD介入封堵治疗可以顺利完成。TTE及TEE是引导ASD介入封堵治疗必不可少的手段。

Objective：To evaluate the value of transthoracic echocardiography（TTE） and transoesophageal echocardiography（TEE） in the interventional therapy of atrial septal defect（ASD）.Methods：Fifty-two ASD patients were underwent with TTE and TEE before the interventional therapy.The occluder sizes were decided by ASD size according to the results of TTE or TEE.The patients were divided into A and B groups according to the monitoring way.TTE was used in all patients for postoperative follow up.Results：The occluders were successfully implanted in 50 patients guided by TTE and TEE.The ASD size measureed before operation was 3~27 mm by TTE and 4~36 mm by TEE.The occluder size was 8~36 mm and 8~40 mm.The ASD size and the occluder size in group A were less than that in group B.There were no significant difference between group A and B in size of ASD or occluder（P0.05）.Close correlation was found between the ASD size measureed by TTE or TEE and the size of the occluders.Postoperative fellow up were taked in 50 patients and the effect was good.Conclusion：TTE and TEE have high value in selecting ASD patients and the size of occlusion device and guiding in transcatheter occlusion of ASD.