经胸超声心动图对室间隔缺损介入治疗适应证选择的应用价值

目的评价经胸超声心动图（TTE）在选择室间隔缺损（VSD）介入治疗适应证方面的应用价值。方法VSD患者62例，男性27例，女性35例，年龄2．5～43岁，平均（14．89士8．5）岁。术前由超声心动图检查严格筛选，确定VSD类型、形态，精确测量缺损大小、残缘距主动脉瓣、三尖瓣根距离，术中指导释放封堵器，术后即刻观察封堵效果。结果62例VSD患者进入导管室，其中4例经X线左室造影后放弃手术，5例封堵失败，53例在TTE和DSA监测下成功封闭VSD（其中2例行二次封堵成功）。成功病例术前TTE测VSD3～17（5．88±2．25）mm，X线左室造影测VSD2～17（5．17±2．63）mm，两者无明显差异，相关性好（r＝0．909），都与封堵器大小存在显著相关。结论TTE在VSD封堵术前适应证方面具有重要应用价值，术中及术后均起着举足轻重的作用。

Evaluation of transthoracic echocardiography to choose indications in transcatheter closure of ventricular septal defect

Objective To assess the value of transthoracic echocardiography (TTE) in the indications selection of transcatheter closure of ventricular septal defect (VSD). Methods Sixty-two patients of VSD selected strictly by echocardiography, including 27 male and 35 female, aged from 2.5 to 43 (mean 14.9±8.5) years, underwent transcatheter closure of VSD. TTE was used for determining VSD types and morphology, and measuring the size of VSD precisely and the distance between residual margin and aortic valve, as well as tricuspid valve before the operation, demonstrating to implant the device during the operation and observing the effect immediately after the operation. Results Transcatheter closure of VSD was successfully obtained in 53 cases under TTE and DSA, but failed in 5 cases, while was cancelled in 4 cases after the left ventricular angiography. The sizes of VSD measured by TTE and DSA were 3 to 17 (mean 5.88±2.25)mm, and 2 to 17 (mean 5.17±2.63)mm by X-ray left ventricular angiography (r=0.909), and both were related remarkably with the size of the device. Conclusion Echocardiography plays a significant role in the closure of VSD before, during and after the operation. TTE is of great value for the indications selection of transcatheter closure of VSD.