彩色多普勒超声心动图在合并肺动脉高压先天性心脏病封堵术中的应用

目的 探讨彩色多普勒超声心动图在先天性心脏病合并肺动脉高压(PH)封堵术中的应用价值.方法 209例伴有PH的先天性心脏病患者在超声全程临测下实施封堵治疗,其中房间隔缺损(ASD)86例,室间隔缺损(VSD)17例,动脉导管未闭(PDA)106例,超声心动图观察肺动脉收缩压(PASP)有无降低及降低的程度.结果 试封堵30～60 min后,合并轻度PH的136例患者PASP均降至正常;中度PH的46例中30例PASP降至正常,16例降至轻度;重度PH的17例中9例PASP降至中度,6例PASP下降≥30 mm Hg.以上患者均行永久性封堵治疗.2例重度PH患者PASP无明显变化,为阻力性PH,未行封堵治疗.结论 彩色多普勒超声心动图可在伴有PH的先天性心脏病封堵术前、术中及术后评估PASP的变化.

Value of transthoracic echocardiography for occlusion of congenital heart disease combined with pulmonary artery hypertension

Objective To evaluate the value of occlusion of congenital heart disease(CHD) combined with pulmonary artery hypertension (PH) by color Doppler echocardiography. Methods Experimental transcatheter closure was performed in 209 patients suffering from CHD with PH, which included 86 cases of atrial septal defect(ASD), 17 cases of ventricular septal defect(VSD) and 106 cases of patent ductus arteriosus(PDA). All patients were occluded experimentally in order to determin whether or not to be the dynamia type of PH. During the process, whether pulmonary arterial systolic pressure(PASP) was stepped down and the degraded degree were detected by echocardiography. Results After 209 cases were done trial occlusion from half an hour to an hour,PASP of 136 cases of lihgt PH patients dropped to normal; in 46 cases of midrange PH patients,PASP of 30 cases dropped to normal,PASP of 16 cases dropped to light; in 17 cases of sever PASP patients,PASP of 9 cases dropped to midrange,PASP of 6 cases stepped down over 30 mmHg,whieh those patients were occluded permanently. PASP failed to respond in 2 cases sever PH after the procedure,implied resistant PH, the permanent transcatheter closure was not recommended and the device was removed. Conclusions PASP can be estimated by color Doppler echocardiography before,during and after occlusion,which could judge reversibility of PH.