封堵未成功膜部室间隔缺损超声心动图诊断与左心室造影及外科手术的对比研究  

Comparison of Echocardiography and Angiography with Surgery from Perimembranous Ventricular Septal Defect Failing in Transcatheter Closure

作　　者：胡雯[1] 刘燕娜[1] 程应樟[2] 黄敏[1] 李沿江[1] 皮小兰[1] 熊祎玭[1] 

机构地区：[1]南昌大学第二附属医院超声科,南昌市330006 [2]南昌大学第二附属医院心血管内科,南昌市330006

出　　处：《中国超声医学杂志》2011年第2期136-139,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析膜部室间隔缺损(VSD)封堵未成功相关因素,以期提高介入治疗膜部VSD的成功率。方法对比分析20例封堵未成功膜部VSD经胸超声心动图(TTE)、左心室造影(LVAG)及外科手术的相关资料。结果 TTE、LVAG及手术见VSD均位于膜部。5例残余分流、4例封堵器移位脱入右室及1例术后溶血患者VSD大小的TTE及LVAG测值均小于手术所见;4例主动脉瓣反流及2例心律失常患者TTE及LVAG测值与手术所见基本一致;3例封堵不完全患者TTE示2例为右室面多孔,LVAG与手术均为右室面多孔;导丝无法通过VSD1例,TTE示单孔,LVAG示多孔,手术为筛孔。结论 TTE检测VSD时应多切面多角度扫查,严格把握介入治疗的适应证,以提高膜部VSD封堵治疗的成功率。Objective To analyze the fail reasons of transcatheter closure in perimembranous ventricular septal defect（VSD） to increase success rate of interventional treatment. Methods The results of transthoracic echocardiography（TTE） ,left ventricular angiography（LVAG） and surgery were analyzed comparatively in 20 cases with perimembranous VSD failing in transcatheter closure. Results The diagnoses of TTE, LVAG and surgery in 20 cases were perimembranous VSD. The measured values of TTE and LVAG were smaller than the results of surgery in 5 cases of residual shunt, 4 cases of displacement or entering into right ventricle and 1 case of haemolysis after occlusion. The measured values of TTE and LVAG were almost the same as the results of surgery in 4 cases of aortic regurgitation and 2 cases of arrhythmia. TTE diagnosed that 2 cases had several apertures in 3 cases of imperfected occlusion. LVAG and surgery diagnosed that all had several apertures. TTE diagnosed that it had only one aperture in 1 case with catheter failing in passing VSD. LVAG diagnosed it had several apertures. Surgery diagnosed the apertures were screen apertures. Conclusions TTE should scan VSD through more incisal surfaces and angles,hold indications strictly to increase success rate of interventional treatment.

关 键 词：超声心动图 室间隔缺损 介入治疗 左心室造影 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]