超声心动图在左室-右房通道诊治中的应用价值  

Application value of echocardiography in diagnosis and treatment of left ventricle-right atrium communication

作　　者：魏薪[1] 张晓玲[1] 孔令秋[1] 朱达[2] 安琪[2] 冯沅[1] 唐红[1] 

机构地区：[1]四川大学华西医院心内科,成都市610041 [2]四川大学华西医院胸心外科,成都市610041

出　　处：《临床超声医学杂志》2015年第9期626-628,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声心动图在左室-右房通道诊治中的应用价值。方法回顾性分析我院4例左室-右房通道患者的术前超声特点、术中超声引导以及术后超声评估情况。结果 4例左室-右房通道患者中,2例为先天性,2例为获得性,皆继发于室间隔缺损修补术后。术前4例患者经胸超声心动图均探及三尖瓣隔瓣附着点与二尖瓣前瓣附着点之间回声中断,彩色多普勒显示一高速血流束由左室经交通口流入右房。实时三维超声心动图清晰显示缺损的形态、大小及毗邻关系。其中3例患者在超声引导下行介入封堵术,术后即刻经食管超声示封堵器未见移位,左室-右房分流消失。结论超声心动图不仅是诊断左室-右房通道的首选方法,而且能实时引导封堵、监测及评估疗效。实时三维超声心动图能更准确、直观地显示其解剖结构,对于手术方式及封堵器型号的选择起着至关重要的作用。Objective To explore the application value of echocardiography in the diagnosis and treatment of left ventricle-right atrium communication.Methods The pre-operation echocardiographic characteristics,ultrasonic gidance during operation and post-operation evaluation in 4 patients who diagnosed as left ventricle-right atrium communication were analyzed retrospectively.Results Two of four patients were congenital,and other two patients were secondary to the repairment of ventricular septal defect.Transthoracic echocardiographic examination revealed a defect between the attachment of tricuspid septal leaflet and mitral anterior leaflet.On color Doppler examination,a turbulent color flow jet from the left ventricular to the right atrium was detected.Real-time 3-dimensional echocardiography accurately displayed the morphology,size and relationship of the defect.Three of the patients underwent transcatheter closer guided by echocardiography and there was no residual shunt between the left ventricular to the right atrium.Conclusion Echocardiography not only is the first choice for diagnosing the left ventricle-right atrium communication,but also can guide the procedure and evaluate the effect.Real-time 3-dimensional echocardiography provides more accurate and visual structure of the defect and plays a central role in choosing the operation approach and the size of the closure device.

关 键 词：超声心动描记术 三维 实时 左室-右房通道 

分 类 号：R540.45[医药卫生—心血管疾病]