经胸超声心动图在膜部瘤型室缺封堵中的应用价值

目的探讨经胸超声心动图（TTE）在膜部瘤型室间隔缺损介入封堵中应用价值。方法2006年6月-2012年12月使用PhilipsSonos5500型彩色超声心动图诊断仪，探头频率为2．5～3．5MHz。通过经胸超声心动图在术前筛选出适合介入封堵的膜部瘤型室间隔缺损83例，术中指导选择合适型号封堵器，一般根据室间隔缺损的最大径加2～4mm选择并引导封堵器的释放，并即刻评价封堵效果，效果满意后释放封堵器。术后1～12个月随访。结果81例封堵成功。植入封堵器后分流消失或为微量残余分流，三尖瓣反流量较术前没有增加。主动脉瓣功能正常。2例封堵不成功。结论经胸超声心动图在膜部瘤型室间隔缺损介入封堵术前选择病例、术中引导和术后随访中有重要价值。精确的室间隔缺损的分型和最大伸展径的测量是膜部瘤型室缺封堵成功的关键。

Utility of transthoracic echocardiogram in transcatheter closure of perimembranous ventricular septal defect with aneurysm

Objective To investigate the utility of transthoracic echocardiogram in transcatheter closure of perimembranous ventricular septal defect with aneurysm. Methods From June 2006 to December 2012,83 cases of perimembranous ventricular septal defect with aneurysm were screened by transthoracic echocardiogram for the transcatheter closure. The oeeluders were selected according to the max diameter of defect. The blocking effect was evaluated immediately. The occluders were released when the blocking effect was obtained. The postoperative follow-up of 1 - 12 months was carried out. Results 81 of 83 cases obtained a satisfactory outcome. The shunting of blood disappeared mostly or completely after the implantation of occluders. Tricuspid regurgitation did not aggravate after the operation. The function of aortic valve was normal. The occlusion operation failed in 2 cases. Conclusion The transthoracic echocardiogram play an important role in the transcatheter closure of perimembranous ventricular septal defect with aneurysm for preoperative case selection,operation guidance and postoperative follow-up. The strict classification of ventricular septal defect and the measurement of maximum spread diameter is key of the closure of perimembranous ventricular septal defect with aneurysm.