心外科房间隔缺损封堵术中经食管超声心动图的应用价值

目的评价经食管超声心动图（TEE）监测房间隔缺损封堵术的临床价值。方法手术前应用经胸超声心动图（TTE）及TEE筛选符合条件的100例单纯房间隔缺损（ASD）患者行封堵术;手术中TEE监测整个封堵过程和引导封堵伞的放置;手术后评价封堵效果、残余分流或并发症等。结果 100例患者均应用TTE和TEE确诊,导引和监测成功闭合房间隔缺损。技术成功96例,成功率96%;4例失败,失败率4%。手术后复查无1例残余分流,3例胸腔积液。经胸超声心动图与TEE诊断结果完全一致率40%,TEE诊断对手术前TTE诊断做出补充或修正诊断的有60例（60%）。结论 TEE对选择适合行封堵术者、选择封堵器大小、指导封堵器的释放、以及疗效评价均具有重要的作用。

The Application of Transesophageal Echoeardiography for Atrial Septal Defect Blockade Operation

Objective To evaluation the clinical role of transesophageal echocardiography（TEE）for atrial septal defect（ASD）blockade operation.Method The 100 patients with ASD were selected on transthoracic echocardiography（TTE）and TEE.During operation,TEE was applied to monitor the procedure of occlusion,to guide the occluder cites,to evaluate the effects and to make sure if there were peripheral residual shunts around the occlusion and other complications.Results All of the patients were exactly diagnosed by TTE and TEE,guiding and evaluating the successful closed ASD.The successful rate of occlusion was 96%,the failure rate was 4%.The review after surgery showed that,there were no residual review,pleural effusion in three patients.The concordance rate of TTE and TEE diagnosis result is 40%.TEE diagnosis amend the preoperative TTE diagnosis in 60 patients（60%）.Conclusions TEE plays an important role in select inpatients,determining the size of the occluder,correctly before occlusion operation,guiding the placement of the occluder in operation and evaluating the effect after operation.