文章摘要
许迪,孔祥清,杨荣,盛燕辉,曹克将,陆凤翔.经食管超声在经导管Amplatzer间隔封堵器修补房间隔缺损中的应用价值[J].南京医科大学学报,2003,17(3):
经食管超声在经导管Amplatzer间隔封堵器修补房间隔缺损中的应用价值
The Role of Transesophageal Echocardiography for Transcatheter Closure of Atrial Septal Defects with the Amplatzer Septal Occluder
  
DOI:10.7655
中文关键词: 经食管超声心动图、房间隔缺损、Amplatzer间隔封堵器
英文关键词: transesophageal echocardiography  atrial septal defects  Amplatzer septal occluder
基金项目:
许迪  孔祥清  杨荣  盛燕辉  曹克将  陆凤翔
南京医科大学第一附属医院心脏科,南京,210029,中国;南京医科大学第一附属医院心脏科,南京,210029,中国;南京医科大学第一附属医院心脏科,南京,210029,中国;南京医科大学第一附属医院心脏科,南京,210029,中国;南京医科大学第一附属医院心脏科,南京,210029,中国;南京医科大学第一附属医院心脏科,南京,210029,中国;Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, P. R. China;
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中文摘要:
      目的:旨在评价经食管超声心动图(TEE)在行Amplatzer间隔封堵器(ASO)经导管修补继发孔型房间隔缺损术中的应用价值.方法:选择继发孔型房间隔缺损患者62例,年龄10~55岁.超声检查用于①术前筛选;②术中采用经食管超声心动图进行封堵术中引导和监测;③术后复查,观察封堵器的位置、周围结构的关系、有无残余分流等.结果:本组患者采用TTE、TEE和球囊X线影像(房间隔缺损最大伸展径)3种测量方法.其结果显示:TTE测值(19.1±5.8)mm与术中球囊测值(25.1±6.4)mm之间存在显著性统计学差异(P<0.001);TEE测值(23.5±6.2)mm与术中球囊测值之间不存在统计学差异(P>0.05).62例患者均在TEE引导和监测下成功地完成ASD封堵.CDFI显示其中61例,封堵器释放后即无左向右分流;1例上腔静脉型ASD患者,靠上腔静脉端有2 mm残余分流.术后即刻、24 h、1个月、3个月、6个月、1年行TTE或TEE检查,62例患者封堵器位置稳定、无移位,未影响周围瓣膜的功能及静脉的回流.1例上腔静脉型ASD患者,1年后靠上腔静脉端仍有2 mm的残余分流;余61例无左向右分流.结论:在经导管Amplatzer间隔封堵器修补ASD术中,TEE可准确地引导和监测封堵器的放置,评估手术疗效.同时,TEE在ASD封堵术中的应用是安全、可行、患者完全可以耐受的.
英文摘要:
      Objective: To evaluate of the role of transesophageal echocardiography (TEE)in percutaneous closure of atrial septal defects (ASD) with the Amplatzer septal occluder. Methods:Sixty-two patients (10 to 55 years of age) were selected for percutaneous closure of ASD by transesophageal echocardiography, which was also used to monitor the procedure, to select the appropriate sizeof the Amplatzer device, to verify its position, and to access the immediate results of the procedure.During the follow-up, transthoracic echocardiography ( TTE) or TEE was used to evaluate the presence and magnitude of residual shunt (RS), device position, and right cardiac chamber diameters. Results: The mean ASD diameter by TTE ( [ 19.1 ± 5.8] mm ) was significantly smaller ( P <0.001 ) than the stretched diameter of the ASD (25.1±6.4) mm. There are no significant differences between the TEE-measured value (23.5±6.2) mm and the stretched diameter of the ASD ( P> 0.05). Due to proper patient selection all procedures were successful. There was immediate and complete closure in 61/62 patients, only one patients had trivial residual shunt. Follow-up was performed using TTE or TEE right after operation, 1 d, 1 month, 3 months, 6 months and yearly thereafter. All patients remain asymptomatic without any clinical or technical problems. Conclusion: With the aid of TEE, percutaneous closure of ASD can be performed successfully, safely, and effectively.
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