超声心动图在房间隔缺损封堵术中的应用

Echocardiographic Guidance for Transcatheter Closure of Atrial Septal Defect

目的 探讨超声心动图在房间隔缺损封堵术中的应用体会。 方法 10例继发孔型房间隔缺损 (直径15～ 2 5 mm )患者在超声心动图检查或结合 X线下球囊充盈测量缺损大小 ,选择封堵器型号 ,监测外科或内科介入性房缺封堵术。 结果 10例房间隔缺损封堵均获得成功。 9例在术中及术后超声心动图随访均无残余分流。 1例双孔房缺 (<5 mm )由一个封堵器修补后残留约 2 mm的细小分流。全部病例术后及随访瓣膜启闭及静脉回流均不受影响。 结论 超声心动图能够正确估测房间隔缺损位置、大小和周边组织情况 ,对房间隔缺损封堵术的病例筛选、术中监测以及术后效果评价均有重要价值 ,对某些病例可以指导封堵器型号的选择。

Objective\ To survey echocardiographic guidance used for the closure of atrial septal defect(ASD) using occlusion device.\ Methods\ Ten patients with secundum ASD ranging from 15 to 25 mm diameter received transcatheter closure through minimally invasive transthoracotomy or right cardiac catheter.\ Transesophageal echocardiography(TEE), or combined with gauge balloon in X\|ray, was used for detection of ASD and its borders, selection of occluder size, and guidance of all closure procedures.\ Results\ All ten patients were treated successfully.\ Nine of them showed no residual shunt with echocardiography during and after operation, and a 2 mm\|wide shunt was found in one patient who had two ASD repaired by one occluder.\ Conclusion\ In the closure of ASD using occlusion device, echocardiography is important in the selection of patient, guidance of closure procedures and follow\|up examinations.\ TEE can also be used for selection of occluder size in some patients.\;