超声心动图在室间隔缺损经导管封堵术中的应用价值

目的 探讨超声心动图在室间隔缺损（VSD）经导管封堵术中的应用方法和价值。方法 4例经导管治疗的室间隔缺损患者,缺损部位1例位于肌部,3例为膜周部。封堵器为Amplatzer式双盘片结构。在经胸超声心动图和X线的引导下,选择封堵器型号比VSD伸展径大1mm。结果 4例VSD成功封堵了3例,3例术前超声心动图测量的缺损大小与实际大小相符,相中2例经导管经右心路径放置封堵器,1例经左心路径放置封堵器成功。封堵术后观察封堵器呈“H”状夹闭VSD,术后即刻穿隔血液消失。术后1周超声心动图复查,3例封堵器位置良好、稳定,无残余分流。结论 超声心动图在VSD封堵术中对病例选择、术中引导和术后随访有重要的实用价值。

The role of echocardiography in transcatheter closure of ventricular septal defect using occluder

Objective To study the role of echocardiography guidance in transcatheter closure of ventricular septal defect (VSD) with Amplatzer occluder.Methods Four patients with VSD located in perimembranous or musular were treated by transcatheter. Under echocardiography and X ray guidance,the occluder size was chosen to 1 mm more than the stretched diameter of VSD.Results Three patients were treated successfully.The image of catheter and occluder was observed by transthoracic echocardiography. The VSD diameter by echocardiography accorded to the stretched diameter of the VSDs. Two cases of VSD were occluded through right heart chamber, and one case of VSD was occluded through left heart chamber. The occluder in VSD showed"H" image after operation,no residual shunt was found by echocardiography immediately and 1 week follow up.Conclusions Echocardiography plays an important role in case selection ,guidance of occluder device replacing and the follow up.