超声心动图评价动脉导管未闭封堵术后心脏结构和心功能变化

The changes of cardia morphology and function after transcatheter closure of patent ductus arteriosus by transthoracic echocardiography

目的探讨超声心动图评价动脉导管未闭（PDA）患者经导管封堵术后心脏结构、血流动力学和心功能的变化。方法经胸超声心动图（TTE）检查确诊为PDA的患者84例,男性22例,女性62例,年龄1～57岁,平均（15.1±13.6）岁。PDA直径1.7～18.7 mm,平均（6.3±3.4）mm。所有患者全部成功施行封堵术。分别于术前、术后48小时、术后1个月、术后3个月、术后6个月及术后1年,采用TTE测定患者心脏结构、血流动力学及心功能指标。结果术后48小时及以后较术前患者左房内径、左室内径、肺动脉内径、二尖瓣口血流速度、主动脉瓣口血流速度、肺动脉收缩压及左室射血分数均减小,差异具有显著性（P〈0.05）;术后1个月及以后患者较术后48小时患者左室内径减小,差异具有显著性（P〈0.05）。结论 PDA封堵术不仅可以有效根治先天性解剖畸形,而且在早期可以迅速纠正血流动力学异常,改善左心几何构型和心功能。

Objective To investigate the ultrasonic Heartbeat map in the evaluation of patent ductus arteriosus（PDA） changes in patients after transcatheter closure of cardiac structure, heart function and hemodynamics. Method Transthoracic echocardiography Beckoning graph（TTE） examination confirmed the diagnosis of 84 cases of PDA patients, male 22 cases, female 62 cases, age 1～ 57 years, mean age（15.1±13.6） years old. PDA diameter of 1.7 ～ 18.7 mm, average diameter was（6.3±3.4） mm. All patients were all successful closure. In the preoperative, postoperative 48 hours, after 1 month, 3 months after the operation, after 6 months and 1 year after operation, determination of cardiac structure, cardiac function and haemodynamics index using TTE. Result 48 hours after operation and later left atrial diameter, left ventricular diameter than the preoperative patients, pulmonary artery diameter, mitral flow velocity, aortic blood flow velocity, pulmonary artery systolic pressure and left ventricular ejection fraction decreased, the difference was significant（P〈0.05）; after 1 month and after patients 48 hours after surgery in patients with left ventricular diameter decreased, the difference was significant（P〈0.05）. Conclusion Transcatheter closure of PDA not only can effectively cure congenital anatomic deformity, and can quickly correct the abnormal hemodynamics in the early, improve left ventricular geometry and heart function.