经食管实时三维超声心动图在经胸微创继发孔型房间隔缺损封堵术中的应用

Application of real-time three-dimensional transesophageal echocardiography in minimal invasive occlusion of secundum atrial septal defect

目的探讨经食管实时三维超声心动图(RT-3D-TEE)在经胸微创封堵术治疗继发孔型房间隔缺损(SASD)中的应用价值。方法对TTE诊断为SASD的58例患者行经胸微创封堵治疗。术前行RT-3D-TEE检查,明确SASD的位置、类型、大小及边缘情况,以选择合适的封堵器;术中于RT-3D-TEE引导下放置封堵器;术后即刻评价封堵效果,1周后复查TTE。结果 58例患者均封堵成功,3例少量残余分流;术后1周TTE检查示封堵器位置正常,均无残余分流。结论 RT-3D-TEE可立体显示SASD的部位、形态及与周围结构的空间关系,对于选择封堵器型号、全方位引导放置封堵器及术后疗效评价具有重要临床应用价值。

Objective To explore the application value of the real-time three=dimensional transesophageal echoeardiography （RT-3D-TEE） in minimal invasive occlusion of secundum atrial septal defect （SASD）, Methods Fifty-eight SASD patients confirmed with TTE underwent transthoracic minimal invasive occlusion. RT-3D-TEE was used to observe the lo- cation, type, size and the surrounding structures of SASD before and during operation in order to choose appropriate model of occluder and monitor the whole process, and the therapeutic effect was evaluated immediately after the surgery. All the patients were rechecked by TTE 1 week after surgery. Results The operations were all successful. Minimal resident shunt was observed in 3 patients. The occluders were all in good position without residual shunt one week after surgery. Conclu- sion RT-3D-TEE can display the position, shape and surrounding structures of SASD in three-dimensional, therefore has important clinical value for choosing appropriate occluder, guiding the placement of oceluder and evaluating therapeutic effect.