经食管超声心动图在房间隔缺损及伴心内其他疾患介入治疗中的应用

Application of transesophag-eal echocardiography in the intervenient procedure in patients with atral septal defect(ASD) and ASD combined with other diseases

目的 探讨经食管超声心动图 (TEE)在房间隔缺损 (ASD)及伴心内其他疾患介入治疗中的应用价值。方法 采用 TEE准确评价 ASD的空间方位、大小和边缘状况 ,及其与周围心内结构的关系 ,并在 TEE引导下对单纯性 ASD、L utembacher综合征 ,Triology of Fallot三联症 (TOF3)、部分适合封堵的房间隔膨胀瘤并ASD、多发性 ASD进行综合性介入治疗。结果 31例中 ,30例用 Amplatzer封堵器对 ASD封堵成功。对伴发的二尖瓣狭窄、肺动脉瓣狭窄于 ASD封堵前行瓣膜球囊扩张术 ;对多发性筛孔状 ASD先行球囊房间隔造口术 ,然后选用匹配的封堵器封堵 ,无残余分流。 1例封堵失败 ,为 ASD伴永存左上腔静脉引流入重度扩张的冠状静脉窦。结论 TEE对于术前病例筛选 ,术中引导心导管、球囊和封堵器送入。

Objective To evaluate transesophag-eal echocardiography(TEE) in the intervenient procedure in patients with atral septal defect(ASD)and ASD combined with other diseases.Methods The dimensional position,area,marginal condition and relation with surrounding structure of ASD were appraised accurately by TEE.ASD,Lutembacher's Syndrome,Triology of Fallot(TOF 3),ASD with septal atrial septal aneurysm that can be closed and multiple ASD were treated by intervenient procedure under the guide of TEE. Results 31 cases patients with ASD were treated with Amplatzer Septal Occluder,30 cases succeed.Percutaneous balloon valvulopla-sty were done previously in patients with mitral or pulmonary valve stenosis.Amplatzer Septal Occluder were implanted successfully in cases with cribriform multiple aral septal defect after balloon septostomy were implemented.1 case combined with permanent persistent left superior vena cava(LSVC) inflowing an extremely expanded sinus vein failed.Conclusion Application of TEE in the intervenient treatment in patients with ASD is efficent in patient selecting,and can guide the inserting,settling and releasing of the guide wire,balloon catheter and occluder.