Ichihashi K, Berger F, Lange P E
Department of Pediatric Cardiology, The German Heart Center of Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Pediatr Cardiol. 2001 Nov-Dec;22(6):503-8. doi: 10.1007/s002460010284. Epub 2001 Dec 4.
To compare the flow pattern of the superior caval vein (superior vena cava; SVC) after catheter therapy with that after open-heart surgery, we examined the flow velocity curves of the SVC in 10 pediatric patients who underwent catheter closure of atrial septal defect (ASD) and in 20 pediatric patients who underwent open-heart surgery. We used pulsed Doppler examinations to record the velocity curves. On the velocity curve of the SVC in children after open-heart surgery, the velocity in systole was lower than that in diastole, which is contrary to the normal pattern. The velocity in systole increased more than that in diastole during inspiration, which also differs from the normal pattern. In contrast, the velocity curve of the SVC in patients after catheter therapy showed a normal pattern. The change of flow velocity during respiration became smaller after treatment in the surgery group, although it did not change after treatment in the catheter group. These results might indicate less reserve ability in the right atrium in patients who undergo open-heart surgery. ASD closure by catheter is useful not only for its economy and noninvasiveness but also for its potential to contribute conservation of right atrial function.
为比较导管治疗后与心脏直视手术后上腔静脉(superior vena cava;SVC)的血流模式,我们检查了10例接受房间隔缺损(ASD)导管封堵术的儿科患者以及20例接受心脏直视手术的儿科患者的上腔静脉血流速度曲线。我们使用脉冲多普勒检查来记录速度曲线。在心脏直视手术后儿童的上腔静脉速度曲线上,收缩期速度低于舒张期速度,这与正常模式相反。吸气时收缩期速度比舒张期速度增加得更多,这也与正常模式不同。相比之下,导管治疗后患者的上腔静脉速度曲线显示出正常模式。手术组治疗后呼吸期间血流速度的变化变小,而导管组治疗后未发生变化。这些结果可能表明接受心脏直视手术的患者右心房储备能力较低。通过导管进行ASD封堵不仅因其经济性和非侵入性有用,而且因其对保留右心房功能的潜在作用而有用。