超声在房间隔膨出瘤并继发孔型房间隔缺损封堵术中的应用

目的 探讨超声心动图在房间隔膨出瘤（ASA）并发继发孔型房间隔缺损（ASD）封堵治疗中的应用价值。方法 应用经食管超声心动图（TEE）或经胸超声心动图（TTE）诊断ASA并发ASD17例，所有患者均在X线和术中TTE监测下行封堵治疗，术后TTE跟踪复查评价其疗效。结果 17例患者封堵器置人均获成功，共放置24个封堵器。封堵器选择的大小与术前判断大小相关性好（r=0．91，P〈0．001）。术后即刻显示17例患者21个封堵器处穿隔血流消失，有3例患者3个封堵器处仍有微量残余分流，术后1个月至3年复查1例有微量分流。结论 ASA并发ASD的患者可行封堵治疗且疗效确切，而超声心动图在病例选择、术中引导等方面有其特殊性，应引起超声医生和临床医生的重视。

Application of echocardiography in transcatheter closure of atrial septal aneurysm associated with secoundum atrial septal defect

Objective To evaluate the value of echocardiography in transcatheter closure of atrial septal aneurysm(ASA) associated with secoundum atrial septal defect(ASD).Methods Seventeen patients who had ASA associated with secoundum ASD were diagnosed by transesophageal echocardiography(TEE) or transthoracic echocardiography(TTE).Guided by X fluoroscopy and TEE,all patients were treated by transcatheter closure,followed up with TTE,and its efficacy was evaluated.Results The placement of the occluders were successful in all 17 patients with 24 occluders.The mean ASD diameter by echocardiography had good correlation with the stretched diameter of ASD(r=(0.91),P<(0.001)).Immediately after the procedure,examined by TTE,ASD was completely closed in 17 cases with 21 occluders,and micro residual shunt was found in 3 cases with 1 occluder respectively.During 1 month-3 years follow-up,residual shunt was found in 1 case.Conclusions Transcatheter closure is feasible for patients who have ASA associated with secoundum ASD and has good result.It is very important that physcian and clinician think highly of its individuality in case selection before transcatheter closure,monitoring and guiding the procedure during transcatheter closure.