经胸彩色超声心动图在先天性心脏病介入封堵术中的应用评价

    The value of transthoracic echocardiography in evaluating curative effect of transcatheter closure of congenital heart diseases

    • 摘要: 目的:探讨经胸彩色超声心动图(TTE)在先天性心脏病封堵术前选择病例和术中及术后疗效观察中的应用价值。方法:术前应用TTE检查,选择适合行先天性心脏病封堵术患者37例,其中20例继发孔型房间隔缺损(ASD),10例膜周部型室间隔缺损(VSD),7例动脉导管未闭(PDA),患者均采用Amplatzer封堵器介入治疗,封堵器选择大于TTE测值的2~4 mm。术中在X线和TTE监测下观察封堵器的释放过程。术后1天、1周、1个月及6个月应用TTE观察封堵伞有无脱落,房、室间隔及大动脉水平有无分流,心脏大小变化。结果:20例ASD封堵成功19例,10例VSD封堵成功10例,7例PDA封堵成功7例。术后1天复查,1例ASD患者有少量残余分流,1例VSD患者三尖瓣瓣下见少量返流,2例VSD封堵术后出现不同程度的传导阻滞。随访1~6个月,均未发现有残余分流。结论:TTE在封堵术前选择合适病例,以及选择封堵器的大小,术中监测封堵器的位置是否准确,术后观察有无残余分流,疗效评价等方面有着重要的作用。

       

      Abstract: Objective: To evaluate the value of transthoracic echocardiography (TTE) in transcatheter closure of congenital heart diseases patients choice before operation,monitoring in operation and observation treatment effect after operation.Methods: Thirty-seven patients with congenital heart diseases were selected by echocardiography before transcatheter closure,in which there were 20 cases of secundum atrial septal defect (ASD),10 cases of ventricular septal defect (VSD),and 7 cases of patent ductus arteriosus (PDA),all of the patients underwent transcatheter closure using the Amplatzer occluder,the diameter occluder device is 2-4 mm wider than measure of echocardiography.The Amplatzer occluder closure procedure which monitored by X-ray and TTE was observed.TTE was performed 1 day,1 week,1 month and 6 months after operation,in order to measure the size of heart and to find whether there were shunts in atrial septum,ventricular septum,large arteries lever and whether the occluder was dropted.Results: The successful transcatheter closure of ASD,VSD and PDA were 19,10,7 cases respectively.One day after operation on TTE,there a slight shunt was detected in 1 case of ASD,a little regurgitation was remained in tricuspid valve of 1 VSD patient,two VSD patients developed a variety of heart block.No shunt was detected in all cases 1-6 months later.Conclusions: TTE has the great usefulness in choosing suitable patients,selecting the size of occluder,examining whether the location is suitable in operation and whether has the residual shunts after operation.It is also important for evaluation of curative effects.

       

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