经胸与经食管超声心动图在室间隔缺损外科封堵中的应用价值

目的:评价经胸与经食管超声心动图在室间隔缺损外科封堵中的价值。方法:2009-08～2011-06经我院心外科确诊的室间隔缺损病人29例。膜周型缺损21例,嵴内型缺损8例。缺损直径3～9mm,平均5.35±3.12mm。术前用经胸超声心动图观察缺损大小及缺损与主动脉瓣的距离。在经食管超声的引导下,经右室游离壁置入国产室缺封堵器。术后用经食管超声即刻评价封堵效果,出院前及封堵3mo后用经胸超声心动图随访观察。结果:25例封堵成功,使用等边封堵器18例,7例偏心封堵器,术后即刻超声及术后超声观察均无分流信号,2例病人术后出现少量三尖瓣反流。2例膜周型缺损TEE发现缺损处有多处破口无法进行封堵。2例嵴内型封堵失败,即刻术中行开胸修补术。结论:经胸与经食管超声心动图在室间隔缺损外科封堵术前评估、术中监测及术后随访中发挥重要的价值。

APPLICATION VALUE OF TTE AND TEE IN DEVICE CLOSURCE OF VENTRICULAR SEPTAL DEFECTS

objective:To access the application value of TTE and TEE in device closurce of ventricular septal defects.Methods:From August 2009 to June 2011,A total of 29 patients diagnosised with VSD(17 males and 12 females)underwent TTE preoperative assessment in the cardial surgical department in our hospital.21 cases with Perimembranous VSD,other 8 cases with intracristal type VSD.The defect diameter ranges from 3mm to 9mm,the average value is 5.35±3.12mm.Used TTE to access defect size and distance from the aortic valve in preoperative.Introduce domestic ventricular septal defect occluder through right ventricular free wall under the guidance of TEE.Immediate evaluate postoperative effect with TEE,TTE was used to follow-up study in the prior to dischargr and three months after.Results:The procedures were successful in 25 cases.Equilateral occluders were used in 18 cases,eccentric occluders in 7 cases.There was no signal of shunt observed by immediate postoperative TEE in the 25 cases,2 patients had mild tricuspid regurgitation after operations.Two cases of perimembranous type of defect with multiple crevasse can not be occludered.Two cases within the intracristal type defect occluder failure,immediate intraoperative thoracotomy neoplasty.Conclusions:TTE and TEE has an important value in the preoperative acessment,intraoperative monitoring and postoperative evaluation in minimally invasive perventricular.