小儿动脉导管未闭封堵术后左右心室功能的研究

目的　评价小儿动脉导管未闭应用Amplatzer封堵器封堵前后及中期随访中的左右心室功能变化。 方法　对 14例患儿术前 ,术后 2 4h及 3个月进行超声检查。左、右室容积采用单面面积 长度法计算 ;测量二尖瓣、三尖瓣、主动脉及肺动脉血流峰值流速。各组数据采用配对t检验。结果　术后左室舒张末内径及容积、每搏量、射血分数均明显减少 ;右室舒张末内径及容积、每搏量、射血分数均明显增大 (P <0 0 5 )。随访中除左室射血分数维持于正常水平外 ,余上述左室指标均继续减少 ;上述右室指标继续增大 (P <0 0 5 )。结论　动脉导管未闭封堵治疗减轻左室容量负荷 ,中期随访左室功能维持于正常水平 ;右室功能持续改善。

Changes of Cardiac Function after Transcatheter Closure of Patent Ductus Arteriosus

Objective To evaluate the changes of left, right ventricular function after transcatheter closure of patent ductus arteriosus (PDA) and during a short term follow up. Methods Fourteen patients with secundum PDA using the Amplatzer duct occluder underwent echocardiographic examination before and after transcatheter closure and during a short term follow up. Left and right ventricular volumes were calculated by the single plane area length method. Results After transcatheter closure, left atrial diameter, left ventricular end diastolic diameter, left ventricular end diastolic volume, left ventricular end systolic volume, left ventricular stroke volume, left ventricular ejection fraction and shortening fraction were significantly decreased ( P <0 05). During follow up, the left ventricular preload was decreased ( P <0 05) and left ventricular function was stable. Right ventricular end diastolic diameter, right ventricular end diastolic volume, right ventricular stroke volume and right ventricular ejection fraction were significantly increased and during follow up they were all increased ( P <0 05). Conclusion Trancatheter closure of PDA can decrease the left ventricular preload. At least during the short term follow up, left ventricular function is stable on normal level while the improvement of right ventricular can be maintained.