膜周部室间隔缺损合并三尖瓣关闭不全的超声诊断分析和封堵术效果观察

目的利用超声心动图二维和三维图像诊断先天性膜周部室间隔缺损(VSD)合并三尖瓣关闭不全(TI),并总结分析经导管封堵术的效果。方法选择已进行VSD封堵术的患者37例,入选条件是术前有明显的三尖瓣关闭不全(TI)。诊断依据:彩色多普勒显示三尖瓣上收缩期高速由右室向右房的逆行血流(TR),运用Simpson法测量TR的容积。疗效评估:比较术前、术后TR容积的变化。结果超声二维和三维图像可清晰显示VSD;37例行封堵术的患者均存在三尖瓣瓣膜或腱索与VSD边缘粘连的情况,比较患者封堵术前后的TR,术前平均为(4.56±1.5)ml,术后减少平均为(1.77±0.86)ml,P<0.05有统计学意义。结论超声心动图二维和三维图像的结合会进一步提高超声诊断的立体定位准确性,封堵术对因粘连引起的TR有明显的治疗效果。

Role of echocardiography in diagnosis of perimembranous VSD companied with tricuspid valve insufficiency occlusion by transcatheter

Objective To evaluate real-time two and three-dimensional (3D) echocardiography in diagnosis of perimembranous ventricular septal defect (VSD) companied with tricuspid valve insufficient (TI) treatment by transcatheter. Methods Thirty-seven patients have undergone the operation of transcatheter closure VSD companied with TI. The tricuspid reguigitation (TR) is confirmed by color echocardiography display showing a systolic flow through the atrioventricular orifice at a high velocity. TR were measured before and after transcatheter operation respectively. Results Two and three-dimensional echocardiographic images can show VSD companied with TI. The devices were successfully deployed in 37 patients TI, which was the result of the TV adherence to the VSD, the TI was improved immediately after occlusion in all patients, tricuspid valve regurgitation decreased from (4.56±1.5)ml to (1.77±0.86)ml, P<0.05. Conclusion The two and three-dimensional echocardiography can provide more information to ensure VSD diagnosed accurately, occlusion successfully and the better prognostic efficacy.