实时三维超声心动图在卵圆孔未闭封堵术中的应用价值  

Value of three-dimensional transesophageal echocardiography in patent foramen ovale closure

作　　者：李晓明[1] 张纯[1] 牛宝荣[1] 吴山[1] 马宁[1] 李嵘娟[1] 张涵[1] 李宜嘉 王月丽[1] 

机构地区：[1]首都医科大学附属北京安贞医院超声心动一部,100029

出　　处：《中国医药》2015年第5期724-727,共4页China Medicine

摘　　要：目的 探讨三维超声心动图在卵圆孔未闭封堵术中的应用价值和意义.方法 对52例卵圆孔未闭患者利用经食管实时三维超声心动图（3D-TEE）进行术前筛查、术中监测和术后评价疗效,并与经胸超声心动图（TTE）进行比较.结果 52例卵圆孔未闭患者中,二维TTE诊断卵圆孔未闭者42例（80.8％）,为通过彩色多普勒血流显像检查发现过隔血流而间接诊断.3D-TEE诊断卵圆孔未闭者52例,准确率达100％.52例患者中46例彩色多普勒显示为左向有分流,仅6例彩色多普勒显示为右向左分流.根据3D-TEE所显示的卵圆孔解剖形态结构,52例患者中Ⅰ型39例（75.0％）,Ⅱ型6例（1 1.5％）,Ⅲ型4例（7.7％）,Ⅳ型3例（5.8％）.术后24 h复查超声心动图,封堵器显示位置正常,塑形良好封堵器与房间隔贴合紧密,房间隔水平未见残余分流.术后1、3及6个月后复查,封堵器形态良好,未见脱落,房间隔水平未见残余分流,所有患者临床均无脑卒中事件发生.结论 3D-TEE在卵圆孔未闭介入封堵中提供了大量重要信息,在术前病例筛选、术中引导、术后随访等方面具有十分重要的意义.Objective To study the application value of three-dimensional transesophageal echocardiography （3D-TEE） in patent foramen ovale （PFO） closure.Methods Totally 52 PFO patients undergoing 3D-TEE and transthoracic echocardiography （TTE） for preoperative screening,intraoperative guidance and postoperative follow-up were retrospectively analyzed.Results In 52 patients,42 （80.8％） showed positive signs in TTE displaying across-septum flow in color doppler flow imaging.Fifty two patients were all accurately diagnosed by 3D-TEE （accuracy rate 100％）.In 3D-TEE,there were 46 showing left to right shunt and 6 showing right to left shunt;there were 39 （75.0％） of type Ⅰ,6 （11.5％） of type Ⅱ,4 （7.7％） of type Ⅲ and3 （5.8％） of type Ⅳ according to the shape of the foramen ovale.It was shown that the position and the shape of the occluder were normal,the occluder was attached closely to the atrial septal,and there was no residual shunt in 3D-TEE 24 h after operation.3D-TEE showed that the shape of the occluder was good without shedding and no residual shout existed 1,3 and 6 months after operation.No cerebral ischemia occurred in all the patients.Conclusions 3D-TEE can provide important information in preoperative screening,intraoperative guidance and postoperative follow-up in transcatheter PFO closure.

关 键 词：超声心动图 实时三维 卵圆孔未闭 封堵 

分 类 号：R540[医药卫生—心血管疾病]