单纯经胸超声心动引导房间隔穿刺在经皮卵圆孔封堵术中的应用  

Transseptal Puncture Guided by Transthoracic Echocardiography in Percutaneous Transcatheter Closure of Patent Foramen Ovale

作　　者：马振 李晓明[2] 杨航[1] 宫一宸[1] 傅元豪[1] 姜新鹏 张喆[1] 傅瑜[3] Ma Zhen;Li Xiaoming;Yang Hang(Department of Cardiosurgery,Peking University Third Hospital,Beijing 100191,China;不详)

机构地区：[1]北京大学第三医院心脏外科,北京100191 [2]首都医科大学附属北京安贞医院介入超声科,北京100029 [3]北京大学第三医院神经内科,北京100191

出　　处：《中国微创外科杂志》2024年第8期540-544,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学第三医院临床重点项目孵育项目B类(BYSYZD2022034);北京大学第三医院临床队列建设项目(BYSYDL2023014);2023北京市重大疑难疾病中西医协同攻关项目示范项目——偏头痛(2023BJSZDYNJBXTGG-015)。

摘　　要：目的探讨单纯经胸超声心动(transthoracic echocardiography,TTE)引导房间隔穿刺(transseptal puncture,TSP)在卵圆孔封堵术中应用的安全性。方法2022年3~12月我科对45例卵圆孔未闭(patent foramen ovale,PFO)单纯鞘管通过法无法通过卵圆孔者,在TTE引导下进行TSP,引导输送鞘管通过后完成卵圆孔封堵治疗。结果45例均成功在TTE引导下完成TSP与封堵术,TSP时间为(15.0±3.7)min,术后即刻及12 h评估无心律失常及心脏穿孔等并发症。均于术后次日康复出院。45例术后3个月门诊随访超声心动图、24 h动态心电图,未发生心内分流、心包积液、心房纤颤、主动脉瓣关闭不全和心律失常等并发症。结论单纯TTE引导TSP安全可行,可作为复杂PFO的补充封堵手段。Objective To assess the safety of transeptal puncture(TSP)guided by transthoracic echocardiography(TEE)in percutaneous transcatheter closure of patent foramen ovale(PFO).Methods From March 2022 to December 2022,our department performed TSP guided by TEE in 45 patients with PFO who were unable to pass through the PFO with transcatheter standard technique.After guiding the delivery of the sheath,the foramen ovale was occluded.Results PFO closure with TSP technique guided by transthoracic echocardiography was successfully finished in all the 45 patients,with an operative time of(15.0±3.7)min.No complications such as arrhythmia or cardiac perforation happened immediately and at 12 h after surgery.All the patients recovered and were discharged on the next day after surgery.All the 45 patients were followed up by outpatient echocardiography and dynamic electrocardiogram at 3 months after surgery,and no complications such as intracardiac shunt,pericardial effusion,atrial fibrillation,aortic regurgitation,or arrhythmia were observed.Conclusion TSP guided by TEE is safe and feasible,and it can be used as a supplementary method for complex PFO.

关 键 词：卵圆孔未闭 房间隔穿刺术 经胸超声心动 

分 类 号：R654.2[医药卫生—外科学]