经胸超声心动图在经胸微创房间隔缺损封堵术中的应用研究

目的:探讨经胸彩色超声心动图(TTE)对经胸微创房间隔缺损(ASD)封堵术病例的选择和术中及术后疗效观察的价值。方法:封堵术前对27例先天性心脏病房间隔缺损患者进行经胸彩色超声测量房间隔的前后径、左右径;房间隔残留端的长度;残留端组织距离房间隔顶部、距离主动脉壁的距离和三尖瓣、二尖瓣、上、下腔静脉口的距离。封堵术中封堵器释放的全过程,主要观察封堵器的房间隔缺损处的位置及张开是否正常、封堵器是否牢固、对瓣膜运动有无阻碍。封堵术后观察心房水平有无残余分流,封堵伞有无脱落,右房、右室、肺动脉内径有无变化,有无二尖瓣、三尖瓣返流。结果:TTE检测27例ASD封堵术患者,TTE测量房间隔缺损平均(14.71±6.42)mm,术后复查患者右房、右室内径缩小,心房水平分流消失。封堵器选择大于TTE测量值的4~6 mm。结论:TTE检查对于术前选择合适的ASD患者,选择ASD封堵器的大小,术中监测封堵器位置是否合适,术后观察有无残余分流,评价疗效有着重要的价值。

Application of Thransthoracic Eclaocardiography in Transcather Closure in Atrial Septal Defect

Objective:To study the application value of transthoracic echocardiography(TTE)in detecting transcather closure in atrial septal defect(ASD)and observation of therapeutic effect.Methods:Before operation,TTE were performed in 27 cases of congenital secundum ASD.The short and long axis views of the interatrial septum,and the length of residual interatrial septum,the distance from ASD to the top of interatrial septum,that to aortic wall,that to tricuspid value,bicuspid value and superior vena cava,inferior vena cava were measured.During operation,the occlusion of defections were monitored,the therapeutic effect were observed.Results:The mean sizes of ASD were(14.71 6.42) mm.Postoperative inner diameter of right cardiac ventricle and atrium decreased and horizontal shunt of atrium diminished.The diameter of occluder was 4 to 6 mm larger than that of ASD detected by TTE.Conclusion:TTE is valuable in selecting proper indictions and occluder,monitoring location of occluder,observing the postoperative residual shunt and evaluating therapeutic effect.