经食管超声心动图在经皮导管房间隔缺损封堵术中的应用价值
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摘要
目的探讨经食管超声心动图(TEE)技术在经皮导管房间隔缺损封堵术中的应用价值。方法选取我院术前经胸超声心动图(TTE)初筛符合封堵条件的房间隔缺损患者32例,术中全麻状态下TEE再次筛查确定,并监测引导经股静脉导管封堵治疗;术后3 d,1、3、6个月TTE随访复查。结果 32例初筛入选患者中,术中TEE再次筛查发现1例距下腔静脉为软边,1例为双孔型间隔缺损,隧行常规开胸心脏直视修补手术;余30例均成功行经皮导管介入封堵治疗。术后3 d,1、3、6个月随访复查,TTE显示封堵器位置正常,房水平分流消失,均未出现脱落及残余分流,无严重并发症出现。结论 TEE引导经皮导管治疗房间隔缺损安全有效,且其在术前筛查、术中引导、术后随访中均具有重要的临床应用价值。
Objective To explore the application value of transesophageal echocardiography(TEE) in percutaneous device closure of atrial septal defect(ASD).Methods A total of 32 patients attacked by ASD were enrolled in this study.All patients received the operation of percutaneous device closure.Transthoracic echocardiography was applied for all the subjects before the operation and TEE was applied during the operation.All patients were followed-up 3 d,1 month,3 month and 6 month after surgery.Results In the 32 cases,2 were converted to open surgery after the second diagnosis by TTE,and 30 received percutaneous device closure successfully.In the follow-up of 3 d,1 month,3 month and 6 month after operation,all the device were in an optimal position and no severe complication happened.Conclusion Percutaneous transcatheter closure under the guidance of TEE is a safe and effective method for ASD.TEE has important clinical value in the diagnosis of ASD before operation,guidance during operation and follow-up after operation.
Objective To explore the application value of transesophageal echocardiography(TEE) in percutaneous device closure of atrial septal defect(ASD).Methods A total of 32 patients attacked by ASD were enrolled in this study.All patients received the operation of percutaneous device closure.Transthoracic echocardiography was applied for all the subjects before the operation and TEE was applied during the operation.All patients were followed-up 3 d,1 month,3 month and 6 month after surgery.Results In the 32 cases,2 were converted to open surgery after the second diagnosis by TTE,and 30 received percutaneous device closure successfully.In the follow-up of 3 d,1 month,3 month and 6 month after operation,all the device were in an optimal position and no severe complication happened.Conclusion Percutaneous transcatheter closure under the guidance of TEE is a safe and effective method for ASD.TEE has important clinical value in the diagnosis of ASD before operation,guidance during operation and follow-up after operation.
引文
[1]张纯,李治安.经食管超声引导下介入封堵治疗房间隔缺损的应用研究[J].心肺血管病杂,2011,30(4):300-302.
[2]Vida VL,Barnoya J,O’Connell M,et al.Surgical versus percutaneous occlusion of ostium secundum atrial septal defects:results and costeffective considerations in a low-income country[J].J Am Coll Cardiol,2006,47(2):326-331.
[3]潘湘斌,逄坤静,胡盛寿,等.经食管超声心动图引导下介入治疗房间隔缺损幼儿的有效性和安全性[J].中华心血管病杂志,2013,41(9):744-746.
[4]韩淑杰,杨俊华,周炳元,等.经胸与经食管超声心动图在房间隔缺损介入治疗中的应用[J].浙江临床医学杂志,2010,12(1):30-32.
[5]Mazic U,Gavora P,Masura J.The role of transcsophageal echocardiography in transcatheter closure of secundum atrial septal defects by the Amplatzer septal occluder[J].Am Heart J,2001,142(3):482-488.
[2]Vida VL,Barnoya J,O’Connell M,et al.Surgical versus percutaneous occlusion of ostium secundum atrial septal defects:results and costeffective considerations in a low-income country[J].J Am Coll Cardiol,2006,47(2):326-331.
[3]潘湘斌,逄坤静,胡盛寿,等.经食管超声心动图引导下介入治疗房间隔缺损幼儿的有效性和安全性[J].中华心血管病杂志,2013,41(9):744-746.
[4]韩淑杰,杨俊华,周炳元,等.经胸与经食管超声心动图在房间隔缺损介入治疗中的应用[J].浙江临床医学杂志,2010,12(1):30-32.
[5]Mazic U,Gavora P,Masura J.The role of transcsophageal echocardiography in transcatheter closure of secundum atrial septal defects by the Amplatzer septal occluder[J].Am Heart J,2001,142(3):482-488.