成人房间隔缺损封堵术后右心结构和功能的变化

目的评价成人房间隔缺损（ASD）封堵术后及随访中右心结构和功能的变化。方法全组96例患者，男41例。女55例。均使用房间隔封堵器治疗。于封堵术前、术后1、6及12个月分别行超声心动图检查。结果术后1个月心电图PR间期、QRS时限、V1导联R波振幅，超声心动图右室横径、右室流出道直径、右房长径、室间隔矛盾运动（PsM）发生率、肺动脉收缩期峰压均较术前明显改普。差异有统计学意义。术后6个月上述指标较术后1个月进一步改善。差异均有统计学意义。术后12个月上述指标与术后6个月时相近，差异无统计学意义。结论ASD封堵术后及短期随访中。右心结构进行性改善，主要表现在右房长径、右室横径、右室流出道直径均进行性改善。右心室的高动力循环状态术后明显减轻。自术后6个月开始，右心保持了正常的结构和功能。

The change of right heart structure and function after occluder device implantation for atrial septal defect

Objective To investigate the change of right heart structure and function after occluder device implantation during the 12 months follow-up in adults. Method Totally 96 patients with 41 males and 55 females underwent device occlusion for atrial septal defect. The echocardiographic tests were performed at 1,6 and 12 months follow-up. Results The PR interval, QRS duration, R wave amplitude of V1, right ventricle (RV) dimension, right ventricular outflow tract (RVOT) diameter, right atrial (RA) dimension, the rate of paradorxical septal movements(PSM) and pulmonary systolic pressure were improved at one month and the further improvement were observed at 6 months follow-up. No statistical significant difference was found between results of 6 months and 12 months. Conclusion After device occlusion for atrial septal defect, the right heart geometry is improved continuously with highlights of RA dimension, RV dimension, RVOT diameter. The hyperdynamic status of RV diminished gradually. The rapid change is stopped at 6 months follow-up. The right heart keep the normal structure and function thereafter.