超声心动图在多孔的2型房间隔缺损封堵术中的应用价值

目的 探讨超声心动图在多孔的2型房间隔缺损（ASD）封堵治疗中的应用价值。方法 应用经食管超声心动图（TEE）或经胸超声心动图（TTE）诊断多孔的2型ASD23例，所有患者均在X-线和术中TTE监测下行封堵治疗，术后TTE跟踪复查评价其疗效。结果23例患者封堵器置入均获成功，共放置38个封堵器。封堵器选择的大小与术前判断大小相关性非常好，相关系数r=0．9，P〈0．001。术后即刻显示18例患者33个封堵器处穿隔血流消失，有5例患者5个封堵器处仍有微量残余分流，术后1个月～3年复查2例有微量分流。结论 多孔的2型ASD患者可行封堵治疗且疗效确切，但超声心动图对病例选择、术中引导等方面有其特殊性，应引起超声医师和临床医师的高度重视。

Echocardiographic Application in Transcatheter Closure of Multiple Foramina Secundum Atrial Septal Defect

Objective To evaluate the value of echocardiography in transcatheter closure of multiple foramina secundum atrial septal defect(ASD).Methods Twenty-three patients who had multiple foramina secundum ASD were diagnosed with transesophageal echocardiography(TEE) or transthoracic echocardiography(TTE).Guided by X fluoroscopy and TTE,all patients were treated with transcatheter closure and the efficacy was evaluated with TTE follow up.Results Thirty-eight occluders were successfully placed in all 23 patients.The mean ASD diameter measured by echocardiography had good correlation with the ASD stretched diameter(r=0.9,P<0.001).Immediately after the procedure examined by TTE,ASD was completely closed with 38 occluders and minimal residual shunt was found in 5 occluders in 5 cases.During 1 month-3 years follow-up,the residual shunt was found in 2 cases.Conclusions Transcatheter closure is feasible for multiple formina secundum ASD patients and has good effects.It is very important that sonographers and doctors should consider individuality cautiously for case selection before transcatheter closure.Echocardiography is neccesary for monitoring and guiding the procedure during transcatheter closure.