房间隔缺损封堵术与外科修补术对左室舒张功能远期影响观察研究

Transcatheter closure of atrial septal defect vs. surgical closure: remote effects on left ventricular diastolic function

目的:比较外科手术和经导管封堵房间隔缺损对左室舒张功能的远期影响。方法:共纳入术后1年以上的经导管封堵房间隔缺损患者37例、外科房间隔缺损修补术患者29例和41例对照组患者。分别测量跨二尖瓣血流多普勒和二尖瓣环组织多普勒速度。结果:对照组跨二尖瓣血流速度E峰明显高于其他两组,E/A比值三组各不相同,在经导管封堵组和外科手术组组织多普勒速度A’均明显高于对照组,其中外科手术组更高。结论:房间隔缺损外科手术对左室舒张功能的影响比经导管封堵更大。

Objective： To study the remote effects of surgical vs. transcatheter atrial septal defect closure on the indices of left ventricular diastolic function. Methods： 66 patients,37 after device and 29 after surgical closure,were evaluated at least 1 year after the procedure. Mitral inflow and tissue Doppler indices were studied. The results were compared to those of 41 control subjects. Results： The early mitral inflow velocities E were higher in controls and E / A ratios were different among all 3 groups. Late diastolic A＇TDI velocities were higher in both device and surgical group patients and more different from the controls in surgical than in device group. Conclusion： It appears that surgical ASD closure alters left ventricular diastolic indices more significantly than device ASD closure.