经胸超声心动图指导Amplatzer封堵器封堵房间隔缺损的研究

目的 研究经胸超声心动图(TTE)指导mnplatzer封堵器(经导管)治疗房间隔缺损(ASD)侧重点的观察及其临床应用价值,以提高对ASD封堵的成功率.方法 门诊ASD患者行TTE检查,主要观察缺损孔直径大小和缺损边缘距周围功能结构的距离.彩色多普勒(CDFI)观察心房分流情况以及ASD是否合并其他心血管畸形.筛选适合封堵的16例ASD患者行TIE引导经导管封堵治疗,术中,TTE引导鞘管将封堵器放置缺损处行封堵,多切面观察封堵器放置的位置,左、右面伞是否平行夹于房间隔边缘两侧,规整呈"(三)"形.CDFI观察是否存在残余分流,封堵器是否影响周围结构功能.结果 16例ASD患者均经TIE指导Amplatzer封堵器封堵成功,术后1周及3个月复查封堵器位置固定,无残余分流.结论 TTE指导Amplatzer封堵器封堵ASD是否成功,术前病例的筛选及封堵器型号的选择是一个重要环节.TTE只要能观察到ASD及周围残余房间隔状况,ASD边缘至周边功能性结构距离符合封堵条件者,TTE是指导Amplatzer封堵器封堵ASD最简便可行的方法,此外,对术后疗效评价有重要的临床价值.

Study of Thransthoracic Echocardiography Guided Amplatzer Device for Occlusion of Atrial Septal Defect

Objective To study the clinical application value and observation emphasis of detecting transcather closure in atrial septal defect(ASD) using amplatzer occlusion device by transthoracic echocardiography(TTE) and to increase successful occlusion rate for ASD. Methods TTE was performed in the outpatients with ASD last two years to observe the ASD pore diameter and the distances from the margins of the ASD to the surrounding functional strctures.Color doppler flow imaging(CDFI) was also performed in these patients to observe the shunts between two atrials and to judge whether there was other cardiorascular malformations.16 patients with ASD indicated for amplatzer closure,TTE was chosen for mornitoring.To observe whether the device looked like " ",or its position was optimal in views by TTE.And whether there was residual shunt or the device affected the surrounding functinal strctures were detected by CDFI.Results Treaments were successed in all 16 patients.And all of them had not residual shunt,and the positions of occlusions were optimal 1 week or 3 months later.Conclusions ASD case selection and occlusion decive selection play an important role for the success of the operations.If TTE can observed the ASD,the rudimentary atrial septum and the distances from the margins of the ASD to the surrounding functionlal strctures,TTE is the easiest and most feasible method for guiding amplatzer device to occluder ASD.In addition,TTE has important clinical value in evaluation of the effect of operation.