摘要
目的 超声心动图引导Amplatzer封堵器经导管关闭房间隔缺损 (ASD)。方法 15例待外科手术的ASD患者 ,超声检查 [12例经食管超声心动图 (TEE)检查、3例经胸超声心动图 (TTE)检查 ]符合条件而准备行经导管ASD封堵术。在超声及X线引导下 ,以ASD最大伸展径或加 1～ 2mm为标准 ,选择Amplatzer封堵器型号 ,导管送封堵器到ASD处、释放 ,腰部卡于ASD口处 ,两伞贴于房间隔两侧。结果 2例患者ASD最大伸展径 >34mm ,没有相应大的封堵器而放弃封堵术 ,其余 13例成功地进行了ASD封堵。超声测量ASD径非常显著小于ASD最大伸展径 [(16 92± 5 35 )mm∶(2 1 38±5 0 1)mm ,P <0 0 1],平均相差 4 46mm。术后立即、2 4h、1个月及 3个月行TTE检查 ,13例患者封堵器位置准确、稳定 ,均无残余分流。所有患者术中及术后均无并发症。结论 用Amplatzer封堵器关闭ASD ,超声在病例的选择、引导封堵器置入及术后疗效观察等方面有极重要、不可替代的作用。
Objective To study the role of echocardiographic guidance in transcatheter closure of atrial septal defect (ASD) with Amplatzer occluder. Methods Fifteen patients with secundum ASD waiting for surgical treatment met the condition by transesophageal echocardiography (TEE) [3 transthoracic echocardiography (TTE)]. The Amplatzer size was chosen to be equal to or 1-2 mm more than the stretched diameter of ASD. Under echo and X ray guidance, the device was advanced to ASD with guiding sheath, and then its left disk, waist and right disk was deployed in turn. Once its position was optimal, it was released. Results Thirteen patients were treated successfully. The mean ASD diameter by echocardiography was significantly smaller than the mean stretched diameter of the ASDs (16 92±5 35 mm vs 21 38±5 01 mm, P< 0 01). The devices′positions were optimal and no residual shunt was found by TTE immediately, 24 hour, 1 month and 3 month after the procedure. No complications were observed during the 3 month follow up. Two patients with stretched diameter >34 mm were given up due to the lack of large size Amplatzers. Conclusion In transcatheter closure of ASD using Amplatzer occluder, Echo plays an important role in case selection, guidance of occluder device replacing and the follow up.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2000年第2期96-98,共3页
Chinese Journal of Cardiology
关键词
房间隔缺损
心脏导管插入术
超声心动图
Atrial septal defect
Cardiac catheterization
Echocardiography
