经皮穿刺闭合房间隔缺损的应用解剖

Applied anatomy of percutaneous closure of atrial septal defect

目的 :为经皮穿刺闭合房间隔缺损提供相关的应用解剖资料。方法 :解剖测量 5 0例 (男 2 9,女2 1)正常成年人心脏标本。结果 :卵圆窝长 (2 0 .9± 5 .4)mm ,宽 (14 .3± 3 .7)mm。卵圆窝中点距冠状窦口中点 (19.7± 4.1)mm ;距膜性房间隔 (2 2 .6± 3 .8)mm ;距三尖瓣隔侧瓣中点 (2 5 .1± 4.2 )mm和距主动脉隆凸底部的中点 (2 4.7± 4.2 )mm。卵圆窝中点距二尖瓣前瓣中点距离为 (19.9± 4.4)mm。卵圆窝缘的厚度在 12、3、6和 9点钟处分别是 (4.1± 0 .7)、(3 .2± 0 .7)、(2 .3± 0 .5 )和 (3 .3± 0 .7)mm。右上、下肺静脉汇入左心房的入口处水平距房间隔的距离分别为 (8.2± 2 .2 )mm和 (12 .4± 3 .8)mm。结论 :依据本文测量结果 ,经皮穿刺闭合房间隔缺损封堵器的厚度在 5mm左右 。

Objective: To provide anatomical basis for percutaneous closure of atrial septal defect.Methods: 50 adult heart specimens (29 male and 21 female) were dissected and measured.Results: The oval fossa was 20.9±5.4 mm long and 14.3±3.7 mm wide.It was 19.7±4.1 mm from the central point of oval fossa to the central point of coronary sinusal ostium, 22.6±3.8 mm to the membranous atrial septum, 25.1±4.2 mm to the middle point of septal tricuspid valve, 24.7±4.2 mm to the central point of the bottom of aortic eminence, 19.9±4.4 mm to the middle point of anterior biscuspid valve.The thickness of the edge of oval fossa was 4.7±0.7 mm at twelve o'clock point, 3.2 ± 0.7 mm at three o′clock point, 2.3±0.5 mm at six o′clock point and 3.3±0.7 mm at nine o′clock point.The distance between the atrial septum and the entrance pionts of right superior and inferior pulmonary veins were 8.2±2.2 mm and 12.4±3.8 mm respectively.Conclusions: It is suggested that the suitable thickness of the apparatus to close the atrial septal defect is about 5mm, and its elasticity must meet the changes of the thickness of atrial septum.