摘要
目的：研究超声心动图在多发房间隔缺损（ASD）封堵术中的应用价值。 方法：应用经胸超声心动图（TTE）及经食管超声心动图（TEE）筛选多发继发孔型ASD患者，在X线及TTE观测下行经皮ASD封堵手术，术后24小时、1个月、3个月、半年行TTE及心电图检查、X线胸片评价疗效。共筛查出42例多发ASD患者，其中38例为双孔ASD患者，3例为中央型筛孔型ASD，1例3孔ASD，男17例，女25例，年龄3~52岁，平均年龄约（32.6±13.4）岁。 结果：采用心尖四腔心切面、胸骨旁大动脉短轴切面及剑下双房心切面测量ASD的大小及间隔距离，大孔上下径9~27 mm[平均（20.7±6.1）mm]，前后径8~23 mm[平均（16.9±5.7）mm]，小孔上下径3~12 mm[平均（6.8±3.6） mm]，二者相距4~18 mm[平均（7.9±2.6）mm]。4例双孔间距超过7 mm的双孔ASD患者（间距为8.7 mm）应用两个封堵器分别封堵两个孔，术后无分流。其他38例采用一个封堵器封堵，封堵器采用14~36 mm进口或国产Amplatzer封堵器，平均约（25.1±6.4）mm，比超声测量值大约（6.9±1.7）mm，均为封堵大孔，手术封堵成功率100%，术后残余分流17例，残余分流率约占40.5%。术后随访6~36个月，平均18.7个月，随访三个月后仅有11例有少量残余分流，占26.2%。
Objective： To evaluate the effect of echocardiography for occluding the multiple seconded atria1 septal defects （ MASD） in relevant patients.
Methods： A total of 42 MASD patients were selected by transthoracic echocardiography （TTE） or transesophageal echocardiography （TEE）. The transcatheter closure was monitored by TTE and X-ray, the effect of treatment was evaluated by TTE, ECG and chest X-ray at 24 hours and 1, 3, 6 months after the procedure. There were 38 patients with 2 defects, 3 with many central small defects and 1 with 3 defects. The patients included 17 male and 25 female with the mean age of （32.6 ± 13.4） years.
Results： The size and distance of the defects were measured with 4 cardiac chambers cross sectional study. The mean diameter of bigger defect from up to down was （9-27） mm, with the mean of （20.7 ± 6.1） mm, from front to back was （8-23） mm, with the mean of （16.9 ± 5.7） mm;the mean diameter of small defect from up to down was （3-12） mm, with the mean of （6.8 ± 3.6） mm. The length of the defect interva1 was （4-18） mm, with the mean of （7.9 ± 2.6） mm. There were 4 patients with 2 defect interval at 8.7 mm who received 2 occluders without post-operative lfow shunt. The rest 38 patients received 1 Amplatzer occluder which was （14-36） mm with the mean of （25.1 ± 6.4） mm which was （6.9 ± 1.7） mm larger than echocardiographic prediction. The success rate of implantation was 100%. There were 17 （40.5%） patients with post-operative lfow shunt. The patients were followed-up for （6-36） months, with the mean of 18.7 months, there were 11 （26.2%） patients with small amount of lfow shunt at 3 months after the operation.
Conclusion： Echocardiography is important for choosing the type and size of occluder devices, in-operative monitoring and post-operative effect evaluation for treating the ASD patients.
出处
《中国循环杂志》
CSCD
北大核心
2014年第11期907-909,共3页
Chinese Circulation Journal
