经食管实时三维超声心动图在经皮卵圆孔未闭封堵中的应用价值  

Application value of real-time three-dimensional transesophageal echocardiography in percutaneous closure of patent foramen ovale

作　　者：郭朝锋[1] 王岩青[1] 王晓静[1] 史景璐[1] 杨再珍[2] 王孝东[2] GUO Chaofeng;WANG Yanqing;WANG Xiaojing;SHI Jinglu;YANG Zaizhen;WANG Xiaodong(Department of Ultrasound Medicine,People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州人民医院超声医学科,郑州市450000 [2]郑州人民医院心脏大血管外科,郑州市450000

出　　处：《临床超声医学杂志》2022年第1期36-39,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨经食管实时三维超声心动图(RT-3D-TEE)在经皮卵圆孔未闭(PFO)封堵术中的应用价值。方法选取于我院行PFO封堵术患者95例,所有患者术前均行经食管超声心动图和右心声学造影(c-TEE)检查证实存在PFO,封堵前应用RT-3D-TEE测量PFO大小、长度、继发间隔厚度,并仔细观察是否存在房间隔膨出瘤、下腔静脉瓣及希阿里网等,然后引导封堵,术后计算手术成功率、手术时间,分析不良反应发生情况,随访患者手术效果。结果95例患者PFO大小为1~7 mm,长度为2~18 mm,其中合并房间隔膨出瘤6例,下腔静脉瓣过长5例,希阿里网4例;左向右分流5例,右向左分流90例。其中94例封堵成功,手术成功率98.95%,平均手术时间为(26.81±5.98)min。4例(4.21%)出现一过性心律失常。术后随访1~3年均无严重并发症发生。结论RT-3D-TEE为经皮PFO封堵术提供了心脏立体结构的三维图像,为提高手术成功率、缩短手术时间和安全地完成封堵手术提供了技术支持,具有重要的应用价值。Objective To investigate the application value of real-time three-dimensional transesophageal echocardiography(RT-3 D-TEE)in percutaneous closure of patent foramen ovale(PFO).MethodsNinety-five patients underwent PFO occlusion in our hospital were selected,and right-heart contrast-transesophageal echocardiography were performed before surgery to confirm the presence of PFO.Before occlusion,the size,length and septum secundum thickness of PFO were measured by RT-3 D-TEE,and the presence of atrial septal aneurysm,inferior vena cava valve and Chiari Network were observed carefully.Then the PFO were closed under the guidance of RT-3 D-TEE.The success rate of surgery and operation time were calculated,the occurrence of adverse reactions were analyzed,and the surgical results of patients were followed up after surgery.ResultsThe PFO of 95 patients ranged in size from 1 to 7 mm and length from 2 to 18 mm,and 6 patients had atrial septal aneurysm,5 patients had long inferior vena cava valve,and 4 patients had Chiari Network.There were 5 cases of left-to-right shunt and 90 cases of right-to-left shunt.Among 95 patients,94 cases were successful in PFO occlusion,the success rate of surgery was 98.95%,the average operation time was(26.81±5.98)min,and 4 cases(4.21%)developed transient arrhythmia.There were no serious complications during 1 to 3 years of follow-up.ConclusionRT-3 D-TEE provides three-dimensional image of cardiac three-dimensional structure for percutaneous PFO closure,which can improve the success rate of surgery,shorten the operation time and safely complete the operation,and has important application value.

关 键 词：超声心动描记术 经食管 三维 实时 卵圆孔未闭 经皮封堵 

分 类 号：R540.45[医药卫生—心血管疾病] R541.1[医药卫生—内科学]