不同型号房间隔缺损封堵器能否影响左心容积和瓣环的运动：三维超声心动图评价

背景：封堵器封堵房间隔缺损具有明确的功能性、安全性和高效性等优势。 目的：运用实时三维超声心动图技术评价房间隔缺损封堵器对左心结构和二尖瓣环运动的影响。 方法：纳入37例确诊为继发孔型房间隔缺损患者，其中男20例，女17例，年龄20-60岁，根据缺损大小及边缘硬度选择对称封堵器进行封堵治疗，分别于封堵前1d、封堵后1个月、封堵后3个月行常规及实时三维超声心动图检查。 结果与结论：选入的37例患者中，有4例因获得的三维超声图像质量欠佳未列入统计，最终33例获得满意的实时三维超声心动图图像并进入分析结果，33例术后封堵器位置均良好。封堵后1，3个月的左心室舒张末期容积、左心室收缩末期容积、左心房舒张末期容积、左心房收缩末期容积均较封堵前增加（P＜0.05），且封堵后3个月效果更显著（P＜0.05）；3个时间点二尖瓣环位移、左心室射血分数相比无差异。封堵器型号与左心房容积变化率、左心室容积变化率呈正相关，心内膜垫残端与二尖瓣环位移无相关性。表明封堵器封堵房间隔缺损可增加左心房、左心室容量，对二尖瓣瓣环运动无影响。

Left ventricular volume and mitral annular motion under different occluders for atrial septal defect occlusion:an evaluation by real-time three-dimensional echocardiography

BACKGROUND：Occluder closure of atrial septal defect exhibits clear function, safety and efficiency advantages OBJECTIVE：Using real-time three-dimensional echocardiography （RT-3DE） technique to evaluate the effect of atrial septal defect occlusion using different occluders on left ventricular structure and motion of the mitral annulus. METHODS：Thirty-seven cases diagnosed as atrial septal defect underwent atrial septal defect occlusion, including 20 males and 17 females, aged 20-60 years. The occluder was chosen individual y according to defect size and edge hardness. Conventional and RT-3DE examinations were performed at 1 day prior to occlusion, 1 and 3 months after occlusion. RESULTS AND CONCLUSION：Four of 37 patients were withdrawn from the study because of poor RT-3DE results. The other 33 patients harvested good occlusion results. At 1 and 3 months after occlusion, left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic＆nbsp;volume were significantly increased （P〈0.05）. Moreover, the more increase in these parameters occurred at 3 months after occlusion （P〈0.05）. There were no significant changes in left ventricular ejection fraction and mitral annular displacement at three different time points. Left ventricular volume change rate and left atrial volume change rate were positively correlated to the type of occluders, while there was no correlation between endocardial cushion stump and mitral annular displacement. These findings suggest that atrial septal defect occlusion can increase the volume of the left ventricle and left atrium, but exhibit no effect on the motion of the mitral annulus.