Gussenhoven E J, van Herwerden L A, van Suylen R J, Ansing T, Witsenburg M, Elzenga N, Quaegebeur J, Bos E
Thoraxcenter Erasmus University, Rotterdam, The Netherlands.
Eur Heart J. 1989 Sep;10(9):801-5. doi: 10.1093/oxfordjournals.eurheartj.a059573.
Intraoperative two-dimensional contrast echocardiography was used to detect a residual shunt in 50 patients after surgical repair of ventricular septal defect. Contrast injections were performed following termination of the extracorporeal circulation. In the presence of a shunt the intensity of opacification of both left and right ventricular cavities was compared. In 40 patients no ventricular shunting was observed; insignificant shunting was noted in five patients. Follow-up of these 45 patients proved uneventful. Significant opacification of the right ventricle was noted in five patients. This finding, however, does not necessarily indicate a residual shunt of significant volume. In two patients the residual shunt was confirmed postoperatively by pulsed Doppler echocardiography but clinically there was no need for surgery. Three other patients subsequently required reoperation and partial patch dehiscence was confirmed in all. Thus, intraoperative two-dimensional contrast echocardiography is a sensitive technique to detect a residual ventricular septal defect, an observation which may warrant reoperation before chest closure.
术中二维对比超声心动图用于检测50例室间隔缺损手术修复后的残余分流。在体外循环结束后进行对比剂注射。若存在分流，则比较左右心室腔的显影强度。40例患者未观察到心室分流；5例患者有轻微分流。对这45例患者的随访结果显示病情平稳。5例患者右心室有明显显影。然而，这一发现不一定表明存在大量残余分流。2例患者术后经脉冲多普勒超声心动图证实有残余分流，但临床上无需再次手术。另外3例患者随后需要再次手术，且均证实有部分补片裂开。因此，术中二维对比超声心动图是检测残余室间隔缺损的一种敏感技术，这一观察结果可能表明在关闭胸腔前有必要再次手术。
