单纯心内超声介导房间隔穿刺术的实验研究

Applications of Intracardiac Echocardiography in Guiding Atrial Septostomy: An In Vivo Study

目的 本实验采用最新的心内超声技术 ,研究单纯超声心动图介导经皮房间隔穿刺术的可能性。方法 8条麻醉犬经右颈外静脉穿刺插入心内超声心动图探头 ,右股静脉穿刺行房间隔穿刺术。使用球囊导管扩张房间隔卵圆孔制造房间隔缺损。术中测量球囊的直径 ,房间隔缺损直径以及过隔血流。术后心脏行病理学检查与术中结果对照。结果 在单纯超声心动图监测下所有犬均成功行房间隔穿刺并扩张制造房间隔缺损 ,平均手术时间为 37± 8.6min。心内超声心动图能够准确描述导管的位置以及与周围结构的关系 ,即时评价房间隔缺损的大小以及过隔血流。球囊直径为 1 0 .0 2± 0 .79cm ,体外测量值 1 2 .41± 0 .0 2cm ,P <0 .0 5。术中房间隔缺损大小 (4.4± 0 .85cm )与术后病理 (4.38± 0 .88cm)无显著性差异。

Purpose To study the possibility of atrial septostomy guided only by a new intracardiac echocardiography.Mothods 8 anesthetic dogs underwent atrial septostomy from right femoral vein, guided only by intracardiac echocardiography while an new novel ultrasound catheter (AcuNav, Acuson Corporation) was put into heart from right jugular vein. Measured balloon's diameter, ASD size and the shunt across atrial septum, compared with the real values of all parameters. Results All atrial septostomy procedures were successfully performed only guided by intracardiac echocardiography, and atrial septum defects were created. Average operative time was 37±8.6 minutes. ICE preciously described the location of the catheter tip and cardiac structures around in details. The diameter of balloon (10.02±0. 79cm) measured in-vivo was smaller than that measured in vitro (12.41±0. 02, P <0.05). The size of ASD measured by ICE (4.4±0. 85cm) was similar with that measured by pathology (4.38±0. 88cm), P >0.05. Conclusion Atrial septostomy can be well done being guided only by intracardiac echocardiography.