经胸与经食管超声心动图在房间隔缺损介入治疗中的应用

目的探讨经胸与经食道超声心动图在房间隔缺损（ASD）经皮介入治疗中的应用。方法选择2005年5月至2009年9月期间在本院接受经皮房间隔缺损封堵术的92例患者，所有患者均经过临床、心电图、X线平片及经食管超声（TEE）和／或经胸超声心动图（TTE）检查诊断为继发孔型ASD，并根据超声心动图检查结果选择封堵器大小，均经股静脉途径放置封堵器，患者术后即刻、1周复查1TrE、心电图。结果共有91例患者封堵成功，1例患者因封堵器脱落行急诊手术，经胸与经食管超声对ASD直接测量，差异有统计学意义。结论ASD介入治疗总体有效，术前慎密综合超声心动图检查结果选择适合封堵术患者及选择封堵器直径是保障治疗成功的关键，经食管超声在ASD经皮封堵术治疗中仍有重要的使用价值。

Clinical application of transthoracic and transesophageal echocardiography in transcatheter closure of atrial septal defect

Objective To study the transthoracic and transesophageal echocardiography in transcatheter closure of atrial septal defect （ASD）. Methods There were 92 patients with ASD accepted transcatheter closure between 2005 and 2009 in the first affiliated hospital of Soochow university, which were diagnosed by clinical manifestation, electrocardiogram, X -ray, transthoracic or transesophageal echocardiography. The size of implanted ASD devices was decided by echoeardiography. TEE guilded the whole process of occlusion and evaluate the effect after operation. Result 91 patients with ASD were treated successfully at one time, there were significant difference between transthoraeic and transesophageal eehocardiography in the size of implanted ASD devices. Conclusion The key for a successful treatment for ASD is to select the device size and appropriate patient for transcatheter closure.TEE plays an important role in diagnosis, helping the device size selection.