经胸B超指导Amplatzer封堵器在治疗成人房间隔缺损中的应用  

Transthoracic echocardiographic guidance for closure of atrial septal defects with amplatzer occlusion device

作　　者：李寰[1] 张玉顺[1] 张军[2] 贾国良[1] 刘建平[1] 何争[1] 姚志勇[3] 李媛[1] 王晓燕[1] 代正学[1] 

机构地区：[1]第四军医大学西京医院心血管内科,710032 [2]第四军医大学西京医院心超声诊断科,710032 [3]第四军医大学西京医院超声诊断科,710032

出　　处：《中国介入心脏病学杂志》2003年第2期71-72,共2页Chinese Journal of Interventional Cardiology

摘　　要：目的　评价经胸B超 (TTE)指导Amplatzer封堵器治疗成人继发孔型房间隔缺损 (ASD)的价值。方法　 30例ASD行Amplatzer封堵术的患者 ,年龄 13～ 6 5岁 ,平均 (32± 15 )岁 ,术前及术中采用TTE指导封堵 ,术后即刻及术后 1个月 ,3个月分别行TTE检查评价治疗效果。结果　 2 4例 (80 % )患者术前和术中直接采用TTE指导封堵成功 ,总有效率为 80 % ;5例 (16 7% )患者术前加做食管B超(TEE)选择适应证 ;1例 (3 3% )患者术中加做TEE指导封堵成功。术中未发生任何重要并发症 ,无急症手术病例。术后即刻TTE彩色多普勒显示 2例 (6 7% )存在微 /少量残余分流 ,术后 1月TTE显示30例患者的ASD完全闭合 ,封堵器形态、位置良好 ,未对毗邻结构产生影响 ,且未见封堵器移位及ASD再通。结论　TTE可用于指导大多数ASD患者行经导管Amplatzer封堵器治疗。Objective To evaluate transthoracic echocardiographic guidance for closure of atrial septal defects with Amplatzer occlusion device in the adults Methods Thirty patients with atrial septal defects were occluded by use of Amplatzer septal occluder The mean age was (32 3±14 7) years (ranging from 13-65 years) Transthoracic echocardiography was undertaken for guidance for closure before and in the procedure of intervention Transthoracic echocardiography was done immediately, one month and three month respectively after intervention to evaluate the treatment efficiency Results Twenty four patients were treated successfully directly by guidance of transthoracic echocardiography during the period of closure, the total effectiveness was 80%. Five patients needed to have transesophageal echocardiography before closure to select indication and another one patient was treated successfully by adding transesophageal echocardiography for guidance in the procedure There was no significant complication that occurred during the procedures, and there was no emergency surgical case Trivial to small residual shunts were found in 2 cases (6 7%) immediately after the procedure No residual shunts were found in the one month follow up, and all patients had no displacement and recanalization in the one month follow up Conclusion Transthoracic echocardiography can guide most of atrial septal defect patients for closure of atrial septal defects with the Amplatzer occlusion device

关 键 词：B超 AMPLATZER 封堵器 治疗 成人 房间隔缺损 封堵术 

分 类 号：R654.2[医药卫生—外科学]