超声心动图与心血管造影在室缺封堵术中的互补价值

目的探讨超声心动图及心血管造影在室间隔缺损(VSD)封堵术中的应用价值。方法VSD封堵术成功患者221例,其中单纯膜部或膜周型209例,嵴内型9例,肌型3例。超声心动图及心血管造影于封堵术前确定VSD类型、大小,缺损残端距瓣膜距离、彩色分流宽度。术后测定封堵器腰大小。结果(1)VSD大小不同切面超声测定VSD大小及彩宽可有差别,心血管造影可测量膜部型VSD大小,对嵴内VSD显示欠佳;(2)VSD残端与瓣膜间距离超声所测VSD残端距主动脉瓣距离与心血管造影测值比较,五腔心切面(5CV)差异无显著性意义(P>0.05);(3)VSD大小与封堵器型号大小及封堵器腰关系超声不同切面VSD大小、彩宽及心血管造影测值与封堵器型号大小比较差异均有显著性意义(P<0.05);大血管短轴切面(AOS)、5CV及心血管造影各测值与封堵器腰之间无显著性差异(P>0.05)。结论X-线透视及心血管造影不能取代超声心动图在封堵介入治疗中的作用;同时,超声心动图尚不能完全替代X-线透视及心血管造影的作用,两者在封堵介入治疗中的作用是相互弥补。

Role of Echocardiography and Angiography in Ventricular Septal Defect Occlusion

Objective To study the role of echocardiography and angiography in ventricular septal defect occlusion(VSDO).Methods Two hundred and twenty-one patients with different VSD types were occluded.Before occlusion,the diameter and the type of VSD,distance from VSD to the aortic valve,tricuspid valve or pulmonary valve were measured,meanwhile,the shunt were observed by color Doppler flow imaging (CDFI).The diameter of occluder waist were measured after occlusion.Results 1.The size of VSD:Different size of VSD and width of CDFI shunt were measured in different views by echocardiography.The size of perimembranous VSD can be accurately measured by angiography,while that of intracristal VSD can not be clearly showed.2.The distance from VSD to valves:Compared with angiography,there were no difference(P>0.05)and significant correlation(r=0.90)in 5 chamber views for the distance from VSD to aortic valve.3.The relationship of the size of VSD,occluder and occluder waist:There were significant differences(P<0.05)in the size of VSD on echocardiography in various views,while the width of CDFI shunt and size of occluder had no difference(P>0.05)between VSD size and occluder waist in AO short axis and 5 chamber views.There was significant difference(P<0.05)between size of VSD measured by angiography and occluder size,but no difference(P>0.05)of these parameters with occluder waist diameters.Conclusions The role of echocardiography can not be displaced with angiography in the VSDO,and,vise versa.They should make up each other for the success of operation.