超声心动图在冠状动脉瘘封堵术中的应用价值

Application value of transthoracic echocardiography in interventional therapy of coronary artery fistulae

目的探讨经胸超声心动图(TTE)在指导经心导管介入治疗冠状动脉瘘(CAF)中的临床价值,以提高介入治疗的成功率。方法 TTE筛选符合介入治疗条件的10例CAF患者行经导管封堵术。术中数字减影血管造影结合TTE全程监测,封堵术后TTE复查以判断疗效。结果 9例在超声指导下一次介入封堵成功,均未见残余分流,1例选用10/12 mm动脉导管封堵器后仍有中量残余分流而放弃封堵,择期行二次介入手术,选用12 mm室间隔小腰大边封堵器,封堵成功。结论 TTE对于介入治疗CAF术前病例选择、术中指导监测及术后疗效评价均有较好的应用价值。

Objective To explore clinical value of transthoracic echocardiography （TrE） in interventional therapy of coronary artery fistulae（CAF）, and to increase success rate of interventional therapy. Methods Ten patients with CAF selected by TFE underwent transcatheter closure. Digital subtraction angiography combined with TrE were used to monitor entire process. After transcatheter closure, TIE was used to judge the effect of operation. Results Under TYE guidance, 9 patients were successfully treated with transcatheter closure without residual shunt. One patient with CAF who used patent ductus arteriosus oceluder still had residual shunt and abandoned the plugging for the first time. The patient who underwent the second interventional operation with ventricular septal defect occluder was successfully plugged. Conclusion TIE has a great application value for interventional therapy of CAF in preoperative case selection, intraoperative monitoring and postoperative effect evaluation.