经食管超声心动图在房间隔缺损经皮封堵术中的应用研究

Appliction Study on Transesophageal Echocardiography in Atrial Septal Defect Treated With Percutaneous Surgical Occlusionn

目的评估经食道超声心动图(TEE)引导下房间隔缺损(ASD)经皮封堵术的优势,进一步评价采用经食道超声心动图引导经皮封堵的可行性和可靠性。方法 58例患者采用经食管超声心动图引导下经皮封堵,选取85例年龄≥6岁经胸封堵成功患者做为对照组,所有患者术前均采用TTE筛查、术中TEE检查及引导下房间隔封堵器释放。所有患者于封堵后3天、1月、3月、6月随访TTE及心电图检查。结果 ASD封堵成功率:经皮组为94%;4例封堵失败,改为经胸小切口封堵成功。经胸组为100%。当ASD后下缘≥6 mm时,经皮封堵成功率增加。所有成功封堵的患者无封堵相关并发症发生。结论经食管超声引导下经皮ASD封堵成功率高,并发症较少,是一种有效、安全的ASD封堵指导方法。

Objective To evaluate the advantages of atrial septal defect（ASD） percutaneous occlusion under transesophageal echocardiography（TEE）, to further evaluate feasibility and reliability of percutaneous occlusion under transesophageal echocardiography. Methods 58 patients received percutaneous occlusion under transesophageal echocardiography, 85 patients older than 6 years of age who underwent successful transthoracic closure were marked as the control group, all patients underwent preoperative TTE screening, intraoperative TEE examination and release of atrial septal defect under the guidance. All patients were followed up for 3 days, 1 month, 3 months, 6 months after occlusion by TTE and electrocardiographic examination. Results Success rate of ASD occlusion： percutaneous group was 94%, 4 cases of occlusion failure, succeeded after changed into transthoracic small incision occlusion. Transthoracic group was 100%. When ASD posterior margin ≥ 6 mm, success rate of percutaneous occlusion were increased. All patients who were occlusion successfully had no complications related to occlusion. Conclusion Success rate of percutaneous ASD occlusion under transesophageal echocardiography is high with less complications, is an effective and safe ASD occlusion guidance method.