经胸超声心动图在先天性左向右分流心脏病封堵术中的应用价值  

Application value of transthoracic echocardiography guided occluded operation for congenital heart disease from left to right shunt

作　　者：李君[1] 李丽[1] 苗风玲[1] 卜凡文[1] 姜莉[1] 

机构地区：[1]内蒙古医学院第三附属医院超声科,内蒙古包头014010

出　　处：《中国冶金工业医学杂志》2007年第6期643-645,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的:探讨经胸超声心动图(TTE)在先天性左向右分流心脏病封堵术中的应用价值。方法:严格筛选病例;使用Amplatzer封堵器;在X线透视及TTE监视下证实封堵器位置合适、多切面观察确定无残余分流及瓣膜返流后,释放封堵器。结果:23例患者均在TTE引导下成功完成封堵治疗。ASD14例TTE测值为6～36mm,平均(21.89±7.71)mm,封堵器型号12～40mm,平均(29.57±8.04)mm;VSD5例TTE测值为5～8mm,平均(6.00±1.10)mm,封堵器型号6～18mm,平均(10.4±4.80)mm;PDA4例TTE测导管直径为5～10mm,平均(6.75±1.92)mm,封堵器型号8～10mm,平均(8.75±0.83)mm。封堵术后即刻分流消失或存在微少量分流。结论:TTE在经导管介入封堵治疗先天性左向右分流心脏病中,起到了术前筛选病例、术中指导释放封堵器、术后监测有无残余分流、评价心脏血流动力学及观察疗效的重要作用。Objective：To determine the utility of transthoracic echocardiography （TTE）guided occluded operation for congenital heart disease from left to right shunt, Methods： To select cases preoperatively according to the guidance of congenital heart disease with transcatheter interventional treatment. The study selected 13 patients with ASD of subsequent foramen pattern, 5 patients with VSD of membrane periphery part and 3 patients with PDA of cast,there were 21 cases in all to use Amplatzer occluder. It selected right or left heart system pathway according to patient＇s ease,then to intubate femoral artery and femoral vein established passage. It＇s time to release Amplatzer device after proving that its location is adaptive by TTE and roentgenoscopy and then being sure that the residual diffluenee and valve reflux weren＇t observed by many-sections exploration. Results： By TTE guidance 21 cases were treated successfully with umbrella occlude. 14 cases was ASD, TTE measured value（21.89 ± 7.71）mm,Amplatzer device model was（29.57±8. 04）mm,5 cases was VSD,TTE measured value（6. 00 ± 1.10）mm,Amplatzer device model was （10. 10±4.80）mm. There were 4cases PDA, TTE（6. 75 ± 1. 92）mm, model （8.75±0.83）mm. Diffluenee disappeared or there was mierotiter shuntings at the immediacy after the occluded operation. Conclusion： TTE plays an important role in transcatheter interventional treatment of congenital heart disease from left to right shunt with Amplatzer device. It involved selecting proper patient before operation, guiding to release Amplatzer device in operation, detecting residual diffluence after operation and evaluating cardiac hemodynamics and observing the treatment efficiency.

关 键 词：超声心动图 先天性心脏病 封堵术 

分 类 号：R541.1[医药卫生—心血管疾病]