超声导引下介入治疗房间隔缺损合并肺动脉瓣狭窄的临床体会

目的本文报告我院1998年10月-2006年11月应用彩色超声（CDE）导引介入治疗房间隔缺损（AsD）合并肺动脉瓣狭窄（Ps）14例的临床体会。方法14例患者，男5例，女9例。年龄3-53岁，平均（20．9士9．8）岁。ASD均为单一中央型。PS轻度6例，中度8例。其中合并卵圆孔未闭和左上腔静脉各l例。使用仪器日本东芝6000型和美国惠普1500型彩色多普勒血流显象仪（CDE）和食道超声（TEE）探头频率分别为2．5MHZ和5MHZ。术前用CDE诊断，术中用CDE及TEE配合术后第2天及随诊均应用CDE。结果应用CDE选择14例ASD合并PS，在CDE和TEE导引及监测下成功进行肺动脉瓣球囊扩张（PBPV）和ASD闭合术，技术成功率100%4，用CDE随诊1～96个月，无任何并发症。结论ASD合并PS介入治疗必须要在CDE和TEE导引及监测下完成CDE主要观察心尖、剑下四腔心、两房心及大动脉短轴切面，TEE主要观察房间隔及上、下腔静脉长轴切面，大动脉短轴及四腔心切面。

Clinical experience of interventional therapy of secundum atrial septal defect accompanied pulmonary valve stenosis assisted by echocardiography

Objective AIM This study reports our clinical experience of intervention therapy of atrial septal defect(ASD) accompanied pulmonary stenosis(PS) under Color Doppler Echocardiographic(CDE) guidance. Methods Between October 1998 and November 2006, 14 patients, 5 males, 9 females, at a mean age of (20.9±9.8) years(ranged from 3 to 53 years old), underwent percutaneous intervention therapy of ASD accompanied PS assisted by CDE. All ASDs were single and central ASDs. 6 patients were mild in PS, or 8 were mediate. 1 accompanied patent foramen ovale(PFO), 1 had left superior vena cava. Color Doppler Flow Imaging (CDFI, Japan Toshiba 6000 and America HP 1500) was used, and detecting frequencies of transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) were 2.5 MHz and 5 MHz respectively. TTE was utilized in diagnosis before procedure, TTE and TEE were used to guide intervention therapy at time of procedure, Follow-up evaluation was performed in by TTE. Results 14 patients underwent successfully percutaneous balloon pulmonary valvuloplasy (PBPV) and closure of ASD assisted by TTE and TEE. Technical success rate was 100%. During 96 months of follow-up, no any complications noted. Conclusion Intervention therapy of ASD accompanied PS should be completed under TTE and TEE guidance and monitoring. TTE mainly observed on cardiac apex, inferior xiphoid process four chamber, couple atrium, great artery and minor axis views and TEE mainly reviewed on atrial septalatri long axis, superior vena cava long axis, inferior vena cava, great artery minor axis and four chambers views.