实时三维超声心动图引导继发孔房间隔缺损封堵术的可行性

The feasibility of real time 3-dimensional echocardiography in independently guiding closure of ostium secundun defect

目的探讨实时三维超声心动图(Realtime3-dimensionalechocardiography,RT-3DE)独立引导继发孔房间隔缺损(Ostiumsecundumdefect,OSD)封堵术的可行性。方法2003-09～12采用PHILIPS公司Sonos7500型超声显像仪独立引导下进行OSD封堵术8例。术前经二维及RT-3DE检查明确诊断;术后经RT-3DE检查证实封堵效果。结果全组技术成功率100%,患者术后6h均可自由活动,1～2d出院。未见残余分流、心律失常、心包填塞、封堵器脱落、栓塞等并发症。随访1～3个月,超声心动图检查无残余分流,封堵器位置良好,右心房及右心室内径均有不同程度缩小。结论单独应用RT-3DE引导OSD封堵术是可行的,并具有真实再现OSD空间立体形态、位置和毗邻解剖关系,无放射线,无需心脏造影检查等其他引导方法无法比拟的优点。

Objective To discuss the feasibility of RT-3DE(Real time 3-dimensional echocardiography)in independently guiding closure of OSD(Ostium secundum defect);and the combination of X-ray with2-DE(2-dimensional echocardiography)and only RT-3DE in guiding the operation were compared.Methods The eight cases of closure OSD had been guided only by PHILIPS Sonos7500Live3D ultrasound system from September to December,2003.The patients were diagnosed by RT-3DE and X-ray before operation,the superior effect of the operation were proved by RT-3DE.Results All the operations were performed successfully,the patients could act freely later six hours after the end of operation,and they could be discharged from the hospital later1-2days;the complications of remnant diffluence,arrhythmia,cardiac tamponade,embolism and the shedding of occluder were not observed.Follow-ups of1-3months,no remnant diffluence could be found,the occluder in right position,and the size of right atrium and right ventride was decreased.Conclusion RT-3DE can guide closure of OSD inde-pendently,and has the advantage of displaying the three-dimensional structure of OSD at real time,the position and the adjacent relation of dissection,what are more the patients needn't X-ray and contrast examination.