经胸超声指导房间隔瘤并继发孔型房间隔缺损的介入封堵  

Transthoracic echocardiography in transcatheter closure of atrial septal aneurysm combined with secoundum-type atrial septal defect

作　　者：孙泽琳[1] 谢启应[1] 杨天崙[1] 蒲晓群[1] 郑昭芬[1] 李传昶[1] 陈晓彬[1] 邓金华[1] 孟霜媛[1] 

机构地区：[1]中南大学湘雅医院心内科,长沙410008

出　　处：《中南大学学报（医学版）》2008年第8期755-760,共6页Journal of Central South University ：Medical Science

摘　　要：目的：探讨经胸超声心动图指导房间隔膨出瘤（atrial septal aneurysm,ASA）并继发孔型房间隔缺损（atrial septal defect,ASD）封堵治疗中的价值。方法：采用经胸超声心动图（transthoracic echocardiography，TTE），必要时结合经食管超声心动图（transesophageal echocardiography，TEE）诊断14例ASA合并ASD成年患者（男3例，女11例）：房间隔瘤均突向右房，基底部宽度13～24（18．5±3．9）mm；膨出深度7～11（9．7±1．8）mm。合并单孔ASD 10例，多孔ASD 4例，彩色多普勒显示左向右分流：所有患者均在X线和术中TTE监测下行介入封堵治疗；术后采用TTE随访，评价其疗效。结果：14例患者均成功进行了介入封堵治疗，共植入国产ASD封堵器14枚。术后即刻无残余分流。随访6～12月，经TTE未见残余分流，封堵器位置固定，无移位等并发症发生。11例（79％）患者心脏大小恢复正常，其余患者心脏有不同程度缩小：结论：ASA并发ASD的患者可行封堵治疗，但有其特殊性，经胸超声心动图在病例选择、术中引导和术后随访等方面具有重要价值。Objective To explore the value of transthoracic echocardiography （3TE） in transcatheter closure of atrial septal aneurysm （ASA） combined with secoundum-type atrial septal defect （ASD）. Methods Fourteen patients （3 males and 11 females） who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projec-ted to the right atrium in all patients, The width of basilar part was 13-24 （ 18.5 ±3.9 ） mm, and in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up. Results Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6-12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients （79%）and were signifantly decreased in 4. Conclusion Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the speciality. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.

关 键 词：经胸超声心动图 房间隔膨胀瘤 继发孔房间隔缺损 封堵 

分 类 号：R541.1[医药卫生—心血管疾病] R732.1[医药卫生—内科学]