房间隔缺损封堵术后Amplatzer封堵器形态变化的研究

Study on profile of Amplatzer septal occluder assessed by transthoracic echocardiography

目的 评价继发孔型房间隔缺损封堵术后Amplatzer封堵器 (ASO)形态的变化。方法 选择经胸超声心动图监测引导封堵房间隔缺损的小儿患者 65例 ,于封堵术后即刻、1个月、3个月、6个月及12个月随访超声心动图 ,观察封堵效果。于房间隔短轴观、心尖四腔观和房间隔长轴观分别测量ASO中心厚度和与腰相连的两侧厚度 ,进行比较分析。结果 所有患者ASO位置正常 ,ASO无移位 ,无并发症发生。 8例患者于术后即刻和 2 4h随访ASO两伞间有微少量血流通过 ,1个月随访时 4例患者微少量血流消失 ,3个月随访时微少量血流全部消失。术后 2 4hASO厚度稍增加 ,术后 1个月、3个月、6个月ASO的厚度回缩明显 ,6个月后ASO的形态趋于稳定。ASO近主动脉侧的厚度大于其他部位的厚度。结论 房间隔封堵术后ASO形态逐渐变薄 ,更牢固地固定于房间隔上。

Objective To evaluate the changes in the profile of the Amplatzer septal occluder(ASO) assessed by transthoracic echocardiography. Methods Echocardiography was performed in 65 children patients with isolated secundum atrial septal defect who underwent percutaneous catheter closure using ASOs immediately after and at 24 hour,1,3,6,12 month follow-up.The thickness of ASOs was assessed in the 4 chamber,short and long axis views of the interatrial septum,and measured at its middle and at the junction of the connecting waist with the disc. Results The position of all the ASOs was normal.No complications were encountered in all the patients.Trivial to small shunts between two discs were found in 8 patients immediately after and at 24 hour follow-up and the shunts were disappointed at 6 month follow-up.ASOs appeared slightly thicker at 24 hour than immediate.All 3 thickness measurements in the 4 chamber,short and long axis views at 24 hour,1,3,6,12 month follow-up,respectively,decreased significantly.The profile of ASOs was stable after 6 months.The thickness of ASOs near the aorta was significantly larger.Conclusions The thickness of the ASOs decreases after deployment,resulting in a more stable closure on the atrial septum.