实时三维超声心动图在先天性心脏病介入封堵治疗中的临床价值

目的评价实时三维超声心动图(RT-3DE)在先天性心脏病介入封堵术前及术后的应用价值。方法RT-3DE检测21例先天性心脏病患者(包括8例房间隔缺损、8例室间隔缺损和5例动脉导管未闭),分析缺损口和未闭导管的空间位置、大小和形态;并于封堵术后RT-3DE评估封堵器的位置及其距主动脉瓣、二尖瓣和三尖瓣等周围组织和血管的距离。结果RT-3DE能实时动态地显示房间隔缺损、室间隔缺损和动脉导管未闭及其封堵器的位置、形态及其与周围组织的关系,其中1例室间隔缺损和2例房间隔缺损因缺损处周边没有足够的边缘组织,改行外科手术。结论RT-3DE在明确先天性心脏病病变的解剖位置,观察封堵器释放后的形态结构,明确残余分流的性质及原因等方面较二维超声心动图具有明显优势。

The clinical value of real time 3D-echocardiography in transcatheter closure of congential heart disease

Objective To evaluate the clinical value of real time three-dimensional echocardiography(RT-3DE) in congenital heart disease(CHD) before and after transcatheter closure.Methods Eighteen patients with CHD(including 8 of ASD,8 of VSD and 5 of PDA) were examined by RT-3DE,and the size,the position and the shape of the defection and patent ductus arteriosus were analyzed,then the position of the occluder and the distance from aortic valve,mitral valve,tricuspid valve and blood vessel were examined by RT-3DE after occlusion operation.Results RT-3DE could display the size,the position,the shape,the tissue surrounding of ASD,VSD,PDA and their occluders vividly.In this study,1 patient of VSD and 1 patient of ASD were decided to do surgery due to there were no enough tissue around the defections.Conclusion RT-3DE has more advantages than 2D-echocardiography in examining the anatomical position of CHD,observing the shape and structure of occluders after operation and identifying the reason of remaining the residue signal of color Doppler flow imaging surrounding occluders.