摘要
目的探讨超声心动图在室间隔缺损(VSD)经导管治疗中的应用价值及评价Amplatzer装置的治疗效果。方法28例VSD患者应用经胸超声心动图(TTE)检查确定VSD部位,测量缺损口长径及其边缘至主动脉瓣和三尖瓣的距离。术中依据超声测值选择封堵器型号,观察封堵器位置及有无残余分流和瓣膜反流,其中1例应用心腔内超声心动图(ICE)监测。术前和术后分别测量左心室舒张期末内径(LVDd)、每搏指数(SVI)和心脏指数(CI)。结果TTE检查确定1例为肌部缺损,另27例为膜周部缺损。VSD与主动脉瓣和三尖瓣的距离均>3mm。缺损口直径为4～13mm,平均(6.81±2.65)mm,封堵器型号为4～16mm,平均(8.71±3.58)mm。28例全部封堵成功,24例无残余分流,4例伴膜部瘤者有少量残余分流,无瓣膜反流。术前和术后LVDd、SVI及CI比较差异有显著性意义。结论超声心动图在VSD介入治疗的术前诊断、术中监测和术后疗效评价中均有重要价值。
Objective To study the echocardiographic value during transcatheter closure of ventricular septal defects(VSD) and therapeutic effect using Amplatzer occluder. Methods Transcatheter closure was conducted on 28 patients with VSD. Before the operation, the minimum distances from VSD to aortic valve and to tricuspid valve were measured by transthoracic echocardiography(TTE). During the operation,the occluders were selected by the TTE measurement. The position of the occluder,and the residual shunt or vavular regurgitation were detected by TTE. One case was observed using the intracardiac echocardiography(ICE). The left ventricular end-diastolic diameter(LVDd),stoke volume index(SVI) and cardiac index(CI) were measured before and after the operation,respectively. Results One patient was diagnosed to have muscular VSD and the other 27 cases were found to have perimembranous VSD through examination. The diameter size of the defects was 4-13 mm, average((6.81)±(2.65))mm. The size of the occluders selected was 4-16 mm, average((8.71)±(3.58))mm. The distances from VSD to aortic valve and to tricuspid valve were more than 3 mm. The treatments for all the patients were successful. Echocardiography showed no residual shunt in 24 patients. The small residual shunt appeared in 4 cases with membranous aneurysms. No patient developed vavular regurgitation. After the transcatheter closure, compared with the condition before, there were significant differences in LVDd,SVI and CI. Conclusions Echocardiography plays an important role in the process of the VSD interventional treatment. The application of Amplatzer device can raise the therapeutic technique of congenital heart diseases to a higher level.
出处
《中华超声影像学杂志》
CSCD
2005年第5期350-353,共4页
Chinese Journal of Ultrasonography
