经胸壁彩超结合球囊法在房间隔缺损经右心导管封堵术中的应用

The value of transthoracic echocardiography in transcathether closure of atrial septal defect

目的 :评价经胸壁彩色超声心动图 (TTE)结合球囊测量法引导房间隔缺损 (ASD)经导管封堵术的可靠性及实用价值。方法 :对 6 7例ASD患者 ,采用TTE结合球囊法测量ASD伸展径后 ,分别置入相应型号Am platzer封堵器。 结果 :6 7例患者TTE引导经右心导管封堵ASD术均成功 ,超声测量的ASD最大伸展径与其实际伸展径一致 ,相关系数 (r ) =0 .97,P <0 .0 0 1。 6 4例ASD封堵器一次放置成功 ,3例第 2次放置成功 ;封堵术成功后即刻彩色超声心动图显示 ,穿隔血流消失 ;术后 3个月复查 ,6 6例封堵器位置良好 ,房间隔无分流 ,右心系统明显回缩 ;1例原有两孔缺损的封堵其中的大孔后残留少量分流。结论 :TTE结合球囊测量法引导ASD经右心导管封堵术成功率高、安全和无痛苦 ,值得推广。

Objective:To evaluate the efficiency of transthoracic echocardiography in transcathether closure of atrial septal defect (ASD). Methods:Sixty seven patients with ASD were implanted Amplatzer device directed by transthoracic echocardiography and transcathether ballon. Results:ASD in sixty seven patients were occluded. The mean ASD diameter measured by echocardiography was correlated with the stretched diameter of ASD ( r= 0.97 , P< 0.001 ). Sixty four patients with ASD were occluded completely at the first time and 3 cases were occluded completely at the second time. No shunt was found immediately after the procedure and after 3 month follow up in 66 cases. The shunt appeared again after 3 weeks in 1 cases who had two ASD with only one occluded. Conclusion:It is effective, safe and painless for transthoracic color echocardiography in transcathether closure of atrial septal defect.