实时三维超声心动图在房间隔缺损介入封堵治疗中的临床价值

目的:评价实时三维超声心动图(RT-3DE)在房间隔缺损介入封堵术前术后的应用价值。方法:RT-3DE检测187例房间隔缺损患者,分析缺损口的空间位置、大小和形态,并于封堵术后RT-3DE评估封堵器的位置及距主动脉瓣、二尖瓣和三尖瓣等周围组织和血管的距离。结果:RT-3DE能实时动态的显示房间隔缺损及其封堵器的位置、形态及其周围组织的关系,其中25例缺损口的下腔静脉端未见残端回声,5例缺损口最大间距为45 mm以上,且缺损口的心房顶部端和下腔静脉未见明显残端回声,1例因缺损处为筛孔状改行外科手术。结论:RT-3DE在明确房间隔缺损的解剖位置、观察封堵器释放后的形态结构、明确残余分流的性质及原因等方面较二维超声心动图具有明显优势。

Clinical value of real time three-dimensional echocardiography in transcatheter closure of atrial septal defect

Objective:To evaluate the clinical value of real time three-dimensional echocardiography(RT-3DE) in atrial septal defect(ASD) before and after transcatheter closure.Methods:187 patients with ASD were examined by RT-3DE,and the size,position and shape of the defect were analyzed,then the position of the occluder and the distances from aortic value,mitral value and tricuspid value were examined by RT-3DE after occlusion operation.Results:RT-3DE could display the size,position,shape and the surrounding tissues of ASD and their occluders vividly.25 patients had no atrial septal retained of inferior vena cava,distance of defect of 5 patients was over 45 mm,and they had no atrial septal retained of atrial top and inferior vena cava,ASD of 1 patients was cribriform and surgery was carried out.Conclusion:RT-3DE has more advantages than 2D-echocardiography in examining the anatomical position of ASD,observing the shape and structures of occluders after operation and identifying the characters and reasons of remaining blood shunt.