彩色多普勒血流显像经胸超声心动图对室间隔缺损介入封堵治疗的价值

 目的探讨彩色多普勒血流显像(Color doppler flow imaging,CDFI)经胸超声心动图(Transthoraic echocardiogram,TTE)在室间隔缺损(Ventricular septal defect,VSD)介入封堵术前、术中及术后的应用价值.方法首先使用CDFI经胸超声心动图扫查选择适合做封堵术的VSD患者,然后监测导管引导Amplatzer封堵器治疗VSD的全过程,在监测过程中认真观察导管及封堵器的位置,配合封堵器的释放,观察封堵器是否已封堵好室间隔缺损处,周边有无残余分流.结果 CDFI经胸超声心动图扫查选择VSD 11例,均为膜部缺损.除1例因VSD上缘距主动脉瓣右冠瓣1.9～2.0mm,缺损口6.0 mm,并有胸骨畸形,封堵术改为经胸手术外,其余10例封堵成功,CDFI未见残余分流.结论 CDFI经胸超声心动图扫查对VSD封堵适应证的选择,封堵术中监测及封堵术后判断及追访均有着重要价值.

Value of CDFI transthoracic echocardiogram in transcatheter closure for ventricular septal defect using Amplatzer occluder

Objective To evaluate the color Doppler flow imaging(CDFI) transthoracic echocardiogram(TTE) in transcatheter closure of ventricular septal defect(VSD) before, during,and after occlusion operation. Methods The selected patients with VSD were treated with Amplatzer occluder.The operations of occlusion were monitored and detected by CDFI TTE. During operations of occlusion,the positions and release of occluder were monitored so as to occlude the VSD firmly. The peripheral residual shunts around the occlusion were observed by CDFI TTE. Results Eleven patients with membranous VSD were selected by CDFI TTE.Except that one patient with a gap at 1.9-2.0 mm to the right semilunar valve of aorta,abnormal sternum and septal defect 6 mm in diameter was given up,the other ten patients were treated successfully,with optimal occlusion and no residual shunt found by CDFI TTE. Conclusion CDFI TTE plays an important role in patient selection, monitoring of occlusion operation and judgement of outcome after the operation.