经食管超声心动图在小婴儿经胸微创室间隔缺损封堵术中的应用

Application of transesophageal echocardiology in the closure of ventriacular septal defect of children

目的评价经食管超声心动图（TEE）在小婴儿经胸微创室间隔缺损封堵术中的应用价值。方法经胸超声心动图诊断为室间隔缺损（VSD）患儿79例，拟行微创非体外循环下封堵治疗。术前行TEE检查，明确室间隔缺损的位置、类型、大小及边缘情况。选择合适的封堵器，术中TEE引导封堵器释放，评价即刻效果。术后1周内复查超声心动图。结果6例患者术前TEE剔除，69例患者封堵成功，4例封堵失败，转体外循环行室间隔缺损修补术。术中TEE显示，64例无残余分流，5例有微量残余分流。术后1周内超声随访，均见封堵器位置良好，1例有微量残余分流。结论TEE对选择适合行封堵的VSD患者、选择合适的封堵器、引导封堵器的释放及疗效评价均具有重要的作用。

Objective To evaluate the applied value of transesophageal echocardiography （TEE） on ventricular septal defect （VSD） closure of children. Methods 79 children with VSD diagnosed by the thransthoracic eehocardiology （rITE） examination prepared to receive preventricular closure of VSD without cardiopulmonary by- pass. ＂lEE was performed before operation to identify the ~SD ~tocation, type, size and the margin state for the purpose of choosing the appropriate occluser, guide the occluser release during operation and evaluate the effect after operation promptly. Then a TIlE was done to evaluate the operative effect a week after the operation. Results 6 cases were deleted before operation by TEE. 69 VSD cases were successfully preventricular closured, of which 64 didn＇t have residue shunt and 5 had minimal shunt by TEE. 1 child received surgical VSD closure with the help of cardiopulmonary bypass. During one week＇s follow up, all ocelusers were all rightly located except one with minimal residual shunt. Conclusion TEE has an important effect in choosing the appropriate cases and the right oecluser, guiding the occluser release and evaluating the closure effect.