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经胸超声心动图在房间隔瘤合并继发孔型房间隔缺损经导管封堵术中的应用

[Transthoracic echocardiography in transcatheter closure of atrial septal aneurysm combined with secoundum-type atrial septal defect].

作者信息

Sun Ze-lin, Xie Qi-ying, Yang Tian-lun, Pu Xiao-qun, Zheng Zhao-fen, Li Chuan-chang, Chen Xiao-bin, Deng Jin-hua, Meng Shuang-yuan

机构信息

Department of Cardiology, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2008 Aug;33(8):755-60.

Abstract

OBJECTIVE

To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD).

METHODS

Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up.

RESULTS

Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4.

CONCLUSION

Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.

摘要

目的

探讨经胸超声心动图(TTE)在房间隔瘤(ASA)合并继发孔型房间隔缺损(ASD)经导管封堵术中的应用价值。

方法

14例ASA合并继发孔型ASD患者,经TTE或经食管超声心动图确诊。所有患者的ASA均突向右心房。基底部宽度约为13~24(18.5±3.9)mm,垂直径约为7~11(9.7±1.8)mm。10例合并单孔ASD,4例合并多孔ASD。所有患者彩色多普勒均显示有左向右分流。所有患者均在X线透视及TTE引导下行经导管封堵术,并在随访期间行TTE检查。

结果

所有患者均成功植入14枚封堵器。术后即刻TTE检查所有患者均未发现残余分流。在6~12个月的随访期间,未发现残余分流或封堵器移位,11例(79%)患者心脏大小恢复正常,4例患者心脏大小明显缩小。

结论

ASA合并继发孔型ASD患者行经导管封堵术是可行的,但需格外注意其特殊性。TTE在经导管封堵术前的病例选择中非常重要,在经导管封堵术中也可用于监测和引导手术操作。

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