超声心动图监测房室间隔缺损封堵术并发症及手术失败原因探讨

目的:评价超声心动图监测经心导管房室间隔缺损封堵术并发症的价值,并探讨手术失败原因。方法:79例房间隔缺损(ASD)、6例膜部室间隔缺损(VSD)患者在经食管或经胸超声心动图(TEE、TTE)监测下行经心导管封堵术。结果:73例ASD、6例VSD封堵成功。6例ASD封堵失败,其中1例封堵器脱落,游离于右心腔内;2例术中心导管戳破左房耳致急性心包填塞;2例因ASD太大缺乏合适尺寸的封堵器而终止手术;1例为筛孔状ASD。1例ASD术后随访有少量残余分流。结论:超声心动图(TTE和TEE)能够正确估测房室间隔缺损的大小和位置,利于术前的病例选择、术中监测封堵器放置和并发症发生。超声检查详尽了解缺损大小和边缘情况在该手术方法中必不可少。

Investigation the failure causes and complications of transcatheter closure of atrial septal defect and ventricular septal defects by echocardiography

Objective:To assess the value of echocardiography in detecting complications and its causes of transcatheter clo-sure for atrial septal defect (ASD)and ventricular septal defect(VSD).Methods:Seventy-nine patients with ASD and6patients with perimembranous VSD underwent transcatheter closure under the guidance of transthoracic(TTE)and*/or transesophageal(TEE)echocardiography.Results:Seventy-three patients with ASD and6with VSD had successful procedures.Six patients with ASD failed.One was due to the detachment of occluding substance floated in the right ventricle,2large ASD due to lack of proper size occluders,2due to acute cardiac tamponade,and1due to the Chiari Network ASD.Mild residual shunt was found in1patient at follow-up.Con clu sion:Echocardiograhy(TEE and TTE)was valuable for selecting patients before operation,guiding the procedure,assessing the efficacy and detecting complications.Echocardiography plays an important role during the procedure.