左心耳封堵术中经食道超声的应用

The application of TEE in percutaneous left atrial appendage occlusion

目的探讨经食道实时超声心动图在左心耳封堵术中的应用方法及价值。方法通过对3例行左心耳封堵术治疗的非瓣膜性房颤患者的经食道超声心动图和血管造影资料进行临床分析。术前经食道超声心动图进行评估,观测左心耳解剖特征,选择合适类型、尺寸封堵器,术中联合血管造影引导、监测封堵器植入过程、评估封堵装置稳定性及密闭性,术后监测并发症及随访。结果 3例患者左心耳封堵均成功,成功率100%,未出现封堵器脱落、栓塞,术后经食道超声心动图及左心耳造影示封堵器位置良好,无残余分流。结论经食道超声心动图可应用于左心耳封堵术的术前、术中及术后,可提高手术的成功率。

Objective To investigate the value of transesophageal echocardiography (TEE) in percutaneous left atrial appendage occlusion. Methods Clinical analysis was performed by TEE and angiographic data in 3 patients with non-valvular atrial fibrillation treated with left atrial appendage occlusion. Preoperative TEE was performed to observe the anatomical features of the left atrial appendage, selecting the appropriate type and size occluder, intraoperative combined angiography guidance, monitoring the occlusion device implantation process, and evaluating the stability and containment of the occlusion device. Postoperative complications and follow-up were monitored. Results 3 patients successfully underwent percutaneous left atrial appendage occlusion. The device was stable. Thrombus, leaks into the left atrial not found. Conclusion TEE can be applied to preoperative, intraoperative and postoperative of left atrial appendage occlusion, which can improve the success rate of surgery.