彩色多普勒超声心动图评价房间隔缺损封堵术后右心形态和功能改变

目的评价房间隔缺损(ASD)患者Amplatzer封堵术后右心房、右心室形态及功能的变化。方法25例继发孔型房间隔缺损患者,男9例,女16例;均行右心导管封堵术,封堵器为Amplatzer式封堵器或国产类似AmplatzerASD封堵器。术前、术中、术后3天、术后3个月分别经胸彩色多普勒心脏检查,观察右心房、右心室大小、三尖瓣反流、肺动脉压力、右室射血分数及左室射血分数。结果25例房间隔缺损患者封堵术后,封堵器位置良好,未见偏移。CDFI:术后3天1例患者封堵器旁见3mm的分流信号,此例患者术后1月复查未见分流信号。余24例术后3天均未见穿隔分流信号。右心房(上下径、左右径)、右心室前后径、长径、横径较术前明显减小。(P<0.05～0.01);三尖瓣反流及肺动脉压力明显降低,(P<0.01);左室射血分数有所升高。3个月后复查右心房、右心室的大小基本恢复正常。结论ASD患者经封堵术后不仅消除了异常分流,而且使右心室的高动力状态得以纠正,也改善了左室收缩功能,彩色多普勒超声心动图能评价心脏的恢复情况。

Color Doppler Echocardiography In Evaluation Of The Morphous And Function of Cor Dextrum After Atrial Septal Defect Occlusion

Objective To evaluate the morphous and function of Cor Dextrum after atrial septal defect(ASD) occlusion using Amplatzer.Methods Nine male and sixteen female patients who suffered from ostium secundum defect underwent cor dextrum occlusion using Amplatzer blockage or similar blockages made in China.Color Doppler echocardiography was used to observe the size of right atrium,right bentricle,tricuspid regurgitation,pulmonary pressure,right ventricular ejection fraction and left ventricular ejection fraction preoperatively,intraoperatively,on the 3rd postoperative day and 3 months after operation.Results The blockages were in the right location after ASD occlusion.CDFI:3mm split stream could be seen beside the blockage on the 3rd postoperative day,and no split stream could be seen a month later.No split stream could be seen in the other twenty-four patients.Right atrium(upper and down diameter,left and right diameter),right ventricle(anteroposterior diameter,transverse diameter and the longest diameter) significantly diminished(P<0.05 or P<0.01);tricuspid regurgitation and pulmonary pressure obviously decreased(P<0.01);left ventricular ejection fraction improved.3 months later,the size of right atrium,right ventricle recovered to normal size.Conclusion The anomalous shift stream was eliminated after ASD occlusion,the hyperkinetic state and left ventricular contractile function also improved.Color Doppler echocardiography can evaluate the recovery status of the heart.