Oflaz Mehmet Burhan, Pac Feyza Aysenur, Kibar Ayse Esin, Balli Sevket, Ece Ibrahim
Department of Pediatric Cardiology, Cumhuriyet University, School of Medicine, Sivas, Turkey.
Department of Pediatric Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
Postepy Kardiol Interwencyjnej. 2013;9(3):205-11. doi: 10.5114/pwki.2013.37497. Epub 2013 Sep 16.
Determining other echocardiographic predictors along with the measured atrial septal defect (ASD) size and evaluating the closure together with these predictors would increase the chance of success for transcatheter closure of ASD.
To evaluate echocardiographic parameters affecting defect closure in children and adult patients with secundum ASD.
In all patients, size of ASD, total length of atrial septum (TS), superior-posterior, inferior-posterior, superior-anterior and inferior-anterior rims surrounding the defect were measured by transesophageal echocardiography (TEE), and several measurement ratios were derived on the basis of TEE parameters.
A total 216 patients with secundum ASD were included in this study. The device was successfully implanted in 65 children and 65 adults. Both in pediatric and adult cases, the ratio of successful closure was found to be significantly higher when the ratio of defect size to TS was ≤ 0.35, the ratio of superior-anterior (SA) rim to the defect size was > 0.75 and the ratio of inferior-posterior (IP) rim to the defect size was > 1.0. It was found that having more than one of these predictors in a single case increased the chance of closure success significantly (p < 0.001).
We concluded that a ratio of the defect size to TS ≤ 0.35, a ratio of SA rim to defect size > 0.75 and a ratio of IP rim to defect size > 1.0 were found to be echocardiographic predictors that could be used in successful transcatheter ASD closure both in children and adults.
确定除已测量的房间隔缺损（ASD）大小之外的其他超声心动图预测指标，并结合这些预测指标评估封堵情况，将增加ASD经导管封堵术成功的几率。
评估影响继发孔型ASD儿童和成人患者缺损封堵的超声心动图参数。
对所有患者采用经食管超声心动图（TEE）测量ASD大小、房间隔总长度（TS）、缺损周围的上后缘、下后缘、上前缘和下前缘，并根据TEE参数得出几个测量比值。
本研究共纳入216例继发孔型ASD患者。65例儿童和65例成人成功植入封堵器。在儿童和成人病例中，当缺损大小与TS的比值≤0.35、上前缘（SA）与缺损大小的比值>0.75、下后缘（IP）与缺损大小的比值>1.0时，成功封堵的比例均显著更高。发现单个病例中具备多个上述预测指标可显著增加封堵成功的几率（p<0.001）。
我们得出结论，缺损大小与TS的比值≤0.35、SA缘与缺损大小的比值>0.75以及IP缘与缺损大小的比值>1.0是可用于儿童和成人ASD经导管封堵术成功的超声心动图预测指标。
