经胸超声在房间隔缺损封堵术前筛选及术中监测中的应用

Application of Transthoracic Echocardiography in Transcatheter Closure of Atrial Septal Defect

目的探讨经胸超声心动图(TTE)在房间隔缺损(ASD)封堵术前评估及术中监测中的应用。方法 96例ASD患者,术前采用TTE筛查,测量主动脉短轴切面、胸骨旁四腔切面、剑下双房切面ASD大小及残余边缘长度。根据测量的ASD直径和缺损周边残端的软硬情况选择合适型号的封堵器,并采用TTE进行术中监测。结果 96例患者中,10例患者未能全部获得各切面清晰图像,其余患者均准确纳入或排除,患者手术顺利,未发生严重并发症。结论对于经胸图像质量良好,经多切面观察ASD效果满意的患者,可单独应用TTE进行术前评估及术中监测,可以根据缺损的最大径平均值选择封堵器型号。

Objective To study the efficacy of only using transthoracic echocardiography （TIE） for preoperative evaluation and intraoperative monitoring of atrial septal defect （ ASD ） occlusion. Methods 96 eases of ASD were recruited, whom received TIE before the operation. The diam- eter of ASD and the edges of the residua from aortic short axis view were measured, as well as the parastemal four chamber view and biatrial view of the vena cava. The ASO size was chosen according to the final diameter of ASD and edge hardness. TTE was used for monitoring during opera- tion. Results Among the 96 eases, 10 patients failed to obtain the clear image of each view, the rest are accurate to include or exclude. All patients had no severe eomphcations. Conclusion For ASD patients, if TTE showed good image, we can use TIE alone for pre-operation evaluation and intraoperative monitoring. In addition, the ASO size can be chosen according to the final diameter of ASD.