超声心动图在外科修补术后室间隔残余漏介入封堵治疗中的应用

目的 探讨外科修补术后残余漏介入封堵治疗的超声心动图筛选适应证及价值.方法 应用HP 5500型彩色多普勒诊断仪检查13例拟行封堵术的残余漏患者,术前观测左右室侧残余漏口大小、漏口残端距主动脉瓣和三尖瓣的距离,术中经胸超声心动图监护引导,术后追踪随访.结果 残余漏部位、残余漏左右室侧大小心血管造影检查与超声心动图结果一致,残余漏距主动脉右瓣距离(2.1±1.6) mm(0～6.9 mm),距三尖瓣(2.3±1.8) mm (0～5.4 mm).所有患者均成功置入封堵器,2例封堵术后少量残余分流,1例于术后3个月消失;1例术后1个月仍有分流,现在随访观察中.结论 超声心动图在外科修补术后间隔残余漏介入封堵术前病例筛选、术中监护引导、术后随访有着其他检查不可替代的临床应用价值.

Echocardiographic monitoring in the occlusion for residual shunt after surgical repair of ventricular septal defect

Objective To explore the value and indications of echocardiography in closing residual shunt after surgical repairing of ventricular septal defect (VSD). Methods Thirteen patients who would be closed residual shunt with occluder after surgical repair of VSD were examined by HP 5500 color Doppler imaging system. Residual shunt sizes, distance to aortic valve and tricuspid valve were measured. During and after operation, echocardiography was used for guiding, monitoring and following-up. Results The residual shunt size and position got from echocardiography were almost correspond with those from left ventricular angiography. The distances from residual shunt to aortic right valve was (2.1±1.6) mm (0-6.9 mm) and to tricuspid valve was (2.3±1.8) mm (0-5.4 mm) respectively. All patients were placed successfully. There were 2 cases with a trivial shunt. One recovered after 3 months and the other was kept a trivial shunt after one month and still is followed up. Conclusion Echocardiography plays an important role in screening candidates, monitoring during occlusion and following-up after operation. Clinically, it is superior to the other examinations.