超声心动图在成人房间隔缺损治疗决策中的作用

目的　探讨超声心动图在成人房间隔缺损(ASD)治疗决策中的作用 ,选择适合的病例进行经皮导管堵闭治疗。方法　本组资料来源于 2 0 0 2年 8月至 2 0 0 3年 8月广东省心血管病研究所 ,12 8例患者经胸超声心动图 (TTE)诊断为继发孔型ASD ,使用TTE筛选和患者同意的 5 2例进行导管堵闭治疗 ,78例患者进行了外科手术治疗。结果　经超声心动图筛选的病例 ,导管介入治疗能有效地关闭 96 %(5 0 /5 2 )的继发孔型ASD ,外科手术修补房间隔缺损的成功率为 10 0 % ,超声心动图显示的房间隔缺损分型与外科术中分型的差异无显著的统计学意义 (P >0 0 5 )。结论　经胸超声心动图能准确的显示成人ASD解剖变异和确定分型 ,经皮导管介入治疗能成功地堵闭绝大多数经超声心动图筛选的患者

Effect of determining using echocardiography on treatment strategy of adult patients with secundum atrial septal defect

Objectives To determine the effect of using echocardiography on treatment strategy in adult patients with secundum atrial septal defect, and to find out such defects suitable or unsuitable for percutaneous catheter closure by Amplatzer device. Methods The data referred to Guangdong Cardiovascular Institute from August 2002 to August 2003, 128 patients was diagnosed as secundum atrial septal defect using transthoracic echocardiography, 52 patients for percutaneous closure and 78 patients for surgery repair.Results 52 patients with secundum atrial septal defect were selected by echocardiography for transcatheter closure and 50 patients (96%) were effectively closed. All 78 patients were successfully closed by surgery repair: The difference of anatomical classification of atrial septal defect between the surgery and echocardiography was no statistical significance.Conclusions Transthoracic echocardiography can exactly demonstrate the anatomical variability and classification of atrial septal defect in adults. Percutaneous closure is possible and can be carried out successfully in a majority of suitable patients with secundum atrial septal defects using echocardiographic screening.