超声心动图在经导管介入封堵VSD中的临床价值

目的评估超声心动图在室间隔缺损（VSD）封堵术前、术中及术后随访中的临床应用价值。方法对临床诊断为VSD并拟行经导管封堵治疗的患者，在封堵术前先行超声心动图检测，多切面测量VSD的部位、大小、距主动脉瓣厦三尖瓣瓣膜的距离等。术中实时监控封堵器安置的过程，应用彩色多普勒血流显像观察封堵器周边有无残余分流。术后定期检查超声心动图进行随访。结果175例VSD患者在超声心动图的引导监控下成功地进行了封堵。封堵术后即刻见19例患者残存少量缝隙分流，2例合并轻度主动脉瓣返流。随访1个月～3年，19例有残余分流患者中11例消失；未见封堵器秽位、脱落。结论超声心动图作为一种安全、简便的检测方法，对于VSD封堵术前的病例筛选、术中监控及术后随访等均具有重要的临床价值。

Value of echocardiography in transcatheter closure of ventricular septal defect

Objective To assess the clinical value of echocardiography in patients with ventricular septal defect(VSD) before,during transcathter closure and on follow-up.Methods Echocardiography was taken before transcatheter closure.The size,position and distance between aortic valve,mitral valve and tricuspid valve of VSD were measured in different echocardiographic sections before transcatheter closure.Procedure of closure was monitored and the peripheral residual shunts were observed by colour doppler imaging.Echocardiography was also taken regularly for follow-up after transcatheter closure.Results Echocardiography was performed in 175 patients with VSD received successfully transcatheter closure.Just after transcatheter closure,trace residual shunts were detected in 19 cases,and moderate aortic regurgitation was found in 2 cases.During follow-up of 1 month to 3 years,residual shunts disappeared in 11 patients.All the occluders were fixed tightly without falling.Conlusion As a safe and simple methods,echocardiography plays an irreplaceable role in selecting patients,guiding the placement of occluder and evaluating the effect.