心腔内超声在“潜在型”卵圆孔未闭封堵术中的应用价值  

Application value of intracardiac echocardiographic guidance in transcatheter closure of latent patent foramen ovale

作　　者：彭松 张晓春 李明飞 张蕾 陈海燕 周达新[2,4] 葛均波 PENG Song;ZHANG Xiao-chun;LI Ming-fei;ZHANG Lei;CHEN Hai-yan;ZHOU Da-xin;GE Jun-bo(Department of Cardiology,Wuhan Fourth Hospital-Puai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei Province,China;Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Echocardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Cardiovascular Disease,Shanghai 200032,China)

机构地区：[1]武汉市第四医院-华中科技大学同济医学院附属普爱医院心内科,武汉430030 [2]复旦大学附属中山医院心内科,上海200032 [3]复旦大学附属中山医院心脏超声诊断科,上海200032 [4]上海市心血管病研究所,上海200032

出　　处：《复旦学报（医学版）》2023年第2期267-272,共6页Fudan University Journal of Medical Sciences

摘　　要：目的探讨心腔内超声(intracardiac echocardiography,ICE)对“潜在型”卵圆孔未闭(patent foramen ovale,PFO)介入封堵术的应用价值。方法回顾性研究复旦大学附属中山医院2021年6—9月收治的术前右心声学造影显示Valsalva动作后出现房水平分流的PFO患者并行介入手术者,根据术中是否运用ICE分为经胸心超(transthoracic echocardiography,TTE)组与ICE组,记录两组的一般情况、超声结果、合并症、并发症、手术时间以及透视时间等临床资料。Pearson法分析术中ICE下测量的卵圆孔直径与术前经食管超声心动图(transesophageal echocardiography,TEE)测量直径的相关性。结果纳入56例患者,其中TTE组37例,ICE组19例。术中ICE下测量的卵圆孔直径与术前TEE下测量的直径呈正相关(R=0.81,P<0.01),术中可以指引导丝通过卵圆孔,减少手术时间和射线照射时间。结论ICE对“潜在型”PFO介入封堵术有显著的应用价值,和TTE相比有更高的成功率和安全性,能减少手术时间和射线照射时间。Objective To investigate the application value of intracardiac echocardiography(ICE)in transcatheter closure of latent patent foramen ovale(PFO).Methods This was a retrospective study of patients admitted to Zhongshan Hospital,Fudan University from Jun to Sep 2021 who showed atrium level shunt after valsalva maneuver by right heart contrast echocardiography and received transcatheter closure.They were divided into transthoracic echocardiography(TTE)group and ICE group according to using ICE or not.The general condition,ultrasound results,comorbidity,complications,operative and fluoroscopy time of two group were recored.Pearson correlation was used to analyze the correlation between diameter of foramen ovale measured by ICE during the operative and transesophageal echocardiography(TEE)before.Results Among 56 patients,there were 37 patients in TTE group and 19 patients in ICE group.Correlation analysis showed that the diameter of foramen ovale measured by ICE was positively associated with TEE(R=0.81,P<0.01).ICE could guide wire to pass through the foramen ovale during operation,which reduced the operation time and radiation exposure time.Conclusion ICE had significant value in transcatheter closure of latent PFO.It has not only a higher successful rate and safety,but also reduce the operation time and radiation exposure time compared to TTE.

关 键 词：心腔内超声(ICE) 卵圆孔未闭(PFO) 经导管介入治疗 

分 类 号：R541.1[医药卫生—心血管疾病]