Sobrino Ayax, Basmadjian Arsène J, Ducharme Anique, Ibrahim Reda, Mercier Lise-Andrée, Pelletier Guy B, Marcotte François, Garceau Patrick, Burelle Denis, O'Meara Eileen, Dore Annie
Department of Medicine. Montréal Heart Institute and Université de Montréal. Montréal, Québec, Canada. División Académica de Ciencias de la Salud. Universidad Juárez Autónoma de Tabasco. Tabasco, México.
Arch Cardiol Mex. 2012 Jan-Mar;82(1):37-47.
The purpose of this paper is to review the usefulness of multiplanar transesophageal echocardiography before, during and after percutaneous transcatheter closure of secundum atrial septal defects. Transesophageal echocardiography imaging techniques,including their role in patient selection, procedural guidance and immediate assessment of technical success and complications are described and discussed in this review. Percutaneous transcatheter closure is indicated for ostium secundum atrial septal defects of less than 40 mm in maximal diameter. The defect must have a favorable anatomy, with adequate rims of at least 5 mm to anchor the prosthesis. Transesophageal echocardiography plays a critical role before the procedure in identifying potential candidates for percutaneous closure and to exclude those with unfavorable anatomy or associated lesions, which could not be addressed percutaneously. Transesophageal echocardiography is also important during the procedure to guide the deployment of the device. After device deployment, the echocardiographer must assess the device (integrity, position and stability), residual shunt, atrio-ventricular valve regurgitation, obstruction to systemic or venous return and pericardial effusion, in order to determine procedural success and diagnose immediate complications.
本文旨在回顾经皮导管封堵继发孔型房间隔缺损术前、术中和术后多平面经食管超声心动图的应用价值。本综述描述并讨论了经食管超声心动图成像技术，包括其在患者选择、手术指导以及对技术成功和并发症的即时评估中的作用。经皮导管封堵适用于最大直径小于40mm的继发孔型房间隔缺损。缺损必须具有良好的解剖结构，至少有5mm的足够边缘以固定封堵器。经食管超声心动图在术前确定经皮封堵的潜在候选者并排除那些解剖结构不佳或有相关病变而无法经皮处理的患者方面起着关键作用。经食管超声心动图在手术过程中指导封堵器的置入也很重要。封堵器置入后，超声心动图检查者必须评估封堵器（完整性、位置和稳定性）、残余分流、房室瓣反流、体循环或静脉回流受阻以及心包积液，以确定手术是否成功并诊断即时并发症。
