长年经食管超声心动图在房间隔缺损封堵治疗中的应用  

Application of transesophageal echocardiography guidingtranscatheter closure of atrial septal defect

作　　者：赵茹[1] 孙根义[1] 张玉兰[1] 王兵[1] 刘玉洁[1] 姜华[1] 陈刚[1] 

机构地区：[1]天津市胸科医院心内科,天津300051

出　　处：《临床心血管病杂志》2004年第2期107-108,共2页Journal of Clinical Cardiology

摘　　要：目的 :经食管超声心动图 (TEE)引导置入Amplatzer封堵器治疗继发孔型房间隔缺损 (ASD)。 方法 :4例ASD患者 ,均为女性 ,年龄 8～ 39( 2 7.75± 13.96 )岁 ,体重 18～ 6 7( 4 2 .0 1± 13.2 0 )kg。在超声和X线透视指导下用Amplatzer双盘封堵ASD。术后重复TEE/经胸超声心动图 (TTE)、ECG及X线平片检查以评价疗效。结果 :4例患者封堵器置入均获成功。术中及术后未发生任何并发症。经TEE测定的ASD直径范围 13～ 2 8mm ,选择封堵器直径为 18～ 32 ( 2 5 .0± 5 .77)mm。术后 2 4h超声心动图显示 4例ASD完全闭合 ,无残余分流。3例完成术后 1个月、1例完成术后 18个月随访均无再通或封堵器移位。结论 :应用Amplatzer封堵器闭合ASD ,TEE在术前选择病例。Objective: To study the role of transesophageal echocardiographic guidance in transcatheter closure of secundum atrial septal defect (ASD) using Amplatzer occluder device.Methods: There were 4 patients with ASD (4 female). The mean age is ( 27.75 ± 13.96 ) years (ranging from 8 to 39 years),and mean weight is ( 42.01 ± 13.20 ) kg (ranging from 18 to 67 kg). Each ASD was occluded using Amplatzer occluder device through the percutaneous procedure under fluoroscopy and TEE. After the procedure TEE was performed immediately to find whether there was any residual shunt remained.TTE, ECG and X ray examination were done 24 hours, 1 month after the procedure to evaluate the efficiency.Results: The placement of the occluders was successful in all 4 patients.No complication occurred during the procedures. The diameter of ASD was 13～28 mm measured by transesophageal echocardiography.The mean diameter of the occluders used was ( 25.0 ± 5.77 ) mm (ranging from 18 to 32 mm).The devices′ positions were optimal and no residual shunt was found by TEE immediately after the procedures.All of 3 patients completed 1 month follow up and there was no residual shunt found.1 patient carried out 18 month follow up and no residual shunt and recanalization were found.Conclusion: Transcatheter closure of ASD using Amplatzer occluder divice is an efficient, feasible and safe nonsurgical method .TEE plays an important role in case selection ,guidance of occluder device replacement and the follow up.

关 键 词：心脏缺损 先天性 超声心动描记术 心脏导管插入术 

分 类 号：R541.1[医药卫生—心血管疾病]