经右胸小切口房间隔缺损封堵术的临床应用

Clinical application of atrial septal defect closure through right minithoracotomy

目的主要探讨经右胸小切口房间隔缺损封堵术的临床应用与临床表现。方法本组女性2例,年龄18～30岁。术中使用双平面经食管探头,经食管行彩色多普勒超声心动图。通过心房两腔观、心尖四腔观及心尖五腔观,扫差房间隔缺损的形状、距离上腔静脉、下腔静脉、主动脉后壁、心房后缘的长度,以及和二尖瓣根部的关系。结果 2例房间隔缺损经封堵均有效。结论该实例说明,此手术路径短,输送器可以精确对准缺损部位释放出封堵伞,位置准确,成功率高;但此手术需要有经验丰富的超声科医生配合为选择封堵器的大小和位置提供信息,确保手术成功。

Objective To investigate the clinical application of atrial septal defect closure through a right minithoracotomy. Methods Two female patients aged 18-30 years were included in the study. In the operation of atrial septal defect closure, transesophageal color Doppler echocardiography was performed using a biplane transesophageal probe. The atrial two-chamber view, apical four-chamber view, and apical five-chamber view were used to determine the shape of atrial septal defect, its distances from the superior vena cava, inferior vena cava, aortic posterior wall, and posterior atrial margin, and its relationship with the base of the mitral valve. Results The atrial septal defect closure was successfully completed in the two cases. Conclusion The atrial septal defect closure has a short operation path, so the occluder can be released to the defect accurately, with a high success rate. Nevertheless, this operation must be performed together with an experienced doctor in the department of ultrasound who can provide information on the size and position of the occluder.