经胸超声心动图对室间隔缺损介入封堵失败10例分析

目的：对室间隔缺损介入封堵失败患者术后行经胸超声心动图复查,总结失败原因,以提高经胸超声心动图术前应用价值。方法：选取10例膜周部室间隔缺损封堵不成功患者。在分析左室造影主要观察指标后,用美国GE公司ViViD型彩色多普勒诊断仪在不同切面于术后重复测量室间隔缺损大小、观察缺损口形态与周围结构的毗邻关系以及各瓣膜的反流程度。结果：10例室间隔膜周部缺损,8例伴有膜部瘤,仅2例为单出口型,瘤体基底部宽度为6～18mm,基底部残端距主动脉瓣环距离0～5mm,距三尖瓣隔瓣距离2～5mm;均伴不同程度三尖瓣返流,其中,中至重度3例;伴有主动脉瓣反流4例,为微量至轻度。无膜部瘤2例。结论：由于经胸超声心动图受影响因素较多,因而对室间隔缺损的定位和大小的测量,应选择多切面、多方向的连续扫查法,严格标准切面,以筛选室间隔缺损封堵术的适应证及合适封堵器大小,保证室间隔缺损封堵术的成功。

Analysis of transthoracic echocardiography of ventricular septal defect intervention sealing failure in 10 cases

Objective：Transcatheter closure of ventricular septal defect patients after failure of transthoracic echocardiography to improve transthoracic echocardiography in the preoperative value,summed up the reasons for failure.Methods：Selected 10 cases of ventricular septal defect occluder unsuccessful cases.Analysis of left ventricular angiography in the main observation indicators,with American GE company ViViD type ultrasonic color Doppler diagnostic apparatus in different section in the size of ventricular septal defect after repeated measurements,observation of morphology and defect population＇s proximity to surrounding structures as well as valve regurgitation.Results：10 cases of ventricular septal defect,combined membranous 8 cases,only 2 cases of single export-oriented,aneurysm of membranous basal width 6-18 mm,from the aortic root from 0-5 mm,separated from the tricuspid valve from the 2-5 mm;that were associated with tricuspid valve regurgitation,moderate to large number of 3 cases,aorta regurgitation in 4 cases,at least for the trace amount.No membranous aneurysm in 2 cases.Conclusion：Because transthoracic echocardiography affected by many factors,so the defect location and size of measurement,should be selected more facets of multi-dimensional continuous scanning method,strict standards section,to screen adaptation of ventricular septal defect occluder certificate and the appropriate closure device size,ventricular septal defect occluder to ensure long-term effects.