超声心动图在Ⅱ孔型房间隔缺损Amplatzer封堵治疗术中的应用

目的探讨超声心动图在筛选Ⅱ孔型房间隔缺损（ASD）病例并引导Amplatzer封堵伞介入方法关闭ASD中的应用价值。方法应用经食管超声心动图（TEE）按Amplatzer封堵法适应证条件筛选7例Ⅱ孔型ASD，经胸超声心动图（TTE）及X线引导进行Amplatzer封堵术。结果1例患者因ASD最大伸展径大于34mm，无相应的封堵伞而放弃封堵术，另1例患者因ASD缺损口距右房顶距离小于3mm，置入Amplatzer封堵伞未能封堵成功，放弃手术治疗，余5例成功进行了Amplatzer封堵术。所有病例TEE测量的ASD直径显著小于ASD最大伸展径［（17.2±1.9）mmvs（26.8±1.3）mm］，5例成功病例术后即刻、24h、1个月、3个月行TTE检查，术后无残余分流，术中、术后无并发症。结论超声心动图在Ⅱ孔型房间隔缺损介入治疗中占有极为重要、不可替代的地位。

Appraisal of application of echocardiography in treatment of atrial septal defect using Amplatzer septal occluder device

Objective　To study the role of echocardiographic guidance in transcatheter losure of ASD with Amplatzer occluder.Methods　Seven patients with ASD were treated using Amplatzer occluder by transesophageal echocardiography (TEE) under transthoracic echocardiography and X-ray guidance.Results　Five patients were treated successfully. The mean ASD diameter measured by echocardiography was significantly smaller than the mean stretched diameter of the ASD′s ［(17.2±1.9)mm vs (26.8±1.3)mm］. The cases were optimal and no residual shunt was found by TTE immediately,24 hour,1 month and 3 month after the procedure.No complications were observed during the 3 month follow-up.One patient with stretched diameter＞34 mm was given up due to the lack of large size Amplatzers and another patient with gap at <3 mm to the top right atrium was also given up. Conclusions　Transthoracic echocardiography is important and irreplacable in the transcatheter closure of ASD using Amplatzer occluder.