摘要
目的探讨超声心动图在外科微创置入Amplatzer封堵器治疗巨大房间隔缺损中的应用价值。方法房间隔缺损患者252例，其中230例缺损大小在34～38mm之间，22例为房间隔膨出瘤合并多孔房间隔缺损。所有病例采用胸骨旁小切口，置入Amplatzer封堵器闭合缺损，术中采用经食管超声心动图（TEE）监测封堵过程，引导封堵器的放置，术后即刻评价疗效，并采用经胸超声心动图（TTE）跟踪随访。结果252例患者在超声心动图监测引导下封堵器置入均获成功，术中即刻应用TEE检查显示252例患者大缺损均获闭合，34例患者封堵器边缘仍存在微量至少量残余分流；术后48h采用TTE复查显示11例患者仍存在少量分流，术后1年随访中6例患者仍有少量残余分流，但同期TTE随访显示右心内径较术前明显减小，基本恢复正常水平，肺动脉压力明显减低。结论超声心动图在选择适合进行外科微创治疗的房间隔缺损患者的术前筛选、术中监测及术后疗效评定方面具有重要作用。
Objective To assess the application value of echocardiography in evaluating minimally invasive Amplatzer closure of great secundum atrial septal defect （ASD） patients. Methods Two hundred and fifty two patients （male,116） were involved in this study. The defect diameter was 34-38 mm in 230 cases, 22cases were atrial septal aneurysm complicating porosity defects. Each patient was positioned a Amplatzer device to close the defect through parasternal minimized surgical incisions. TEE were used to monitoring the whole procedure, to guide the device placing and evaluate the curative effect instantly after operation. Results All patients were successfully positioned closure devices by echocardiography monitoring. Only 34 cases had micro to small amounts residual shunt instantly after operation, 11 cases still had small amounts residual shunt at the time of 48 hours after the operation. In the one year follow-up,6 cases had residual shunt, but the diameters of right chamber heart were significantly reduced than preoperative,and the pulmonary artery systolic pressure were also reduced. Conclusions Echocardiography possesses important role of preoperative patients screening,monitoring the devices deploying intraoperation, and evaluating the curative effect postoperative.
出处
《中华超声影像学杂志》
CSCD
北大核心
2009年第8期653-656,共4页
Chinese Journal of Ultrasonography
关键词
超声心动描记术
房间隔缺损
外科手术
微创性
Echocardiography
Heart septal defects, atrial
Surgical procedures, minimally invasive
