经胸超声心动图在引导房间隔缺损经右心导管封堵术中的临床价值

目的　评价经胸彩色多普勒超声引导经导管房间隔缺损 (ASD)封堵术的可靠性及应用方法。方法37例房间隔缺损患者 ,采用经胸彩色超声心动图检查 ,多个切面综合判断房间隔缺损的伸展径。比较超声测量值与封堵成功所选用的封堵器大小之间的相关性。结果　 35例患者经胸超声引导经右心导管封堵房间隔缺损术成功 ,超声测量的最大伸展径与ASD实际最大伸展径一致 ,r =0 .97,P <0 .0 0 1。 33例ASD封堵器一次放置成功 ,2例测量偏小 ,第二次放置成功 ;封堵术成功后即刻彩超显示穿隔血流消失 ;术后 3月复查 ,房间隔无穿隔血流 ,右心系统明显回缩。结论　经胸彩色多普勒超声引导经右心导管房间隔缺损封堵术准确性高 ,方法简便 ,无痛苦 ,值得推广。

Clinical valuation of transthoracic color echocardiography in transcatheter closure of atrial septal defect

Objective To evaluate the efficiency and clinical application of transthoracic color echocardiography in transcatheter closure of atrial septal defect(ASD).Methods Thirty seven patients with ASD were detected by transthoracic color echocardiography and compared with Amplatzer devicer used by operation.Results Thirty five patients with ASD were occluded completely without residual shunt.The mean ASD diameter by echocardiography has good correlationship with the stretched diameter of ASD (r= 0.97 ,P< 0.001 ).Thirty three patients,ASD were occluded completely at first time; 2 patients,ASD were occluded completely at second time,for the ASD diameter by echocardiography was smaller than the stretched diameter of ASD.No shunts were found immediately after the procedure and after 3 month follow up,the diameter of right atrium,right ventricle were decreased significantly in all patients.Conclusions It is an effective,painless and simple method of transthoracic color echocardiography in transcatheter closure of atrial septal defect.