Rosenfeld H M, van der Velde M E, Sanders S P, Colan S D, Parness I A, Lock J E, Spevak P J
Department of Pediatric Cardiology, Children's Hospital, Boston, Massachusetts 02115, USA.
Cathet Cardiovasc Diagn. 1995 Jan;34(1):29-34. doi: 10.1002/ccd.1810340308.
We reviewed pre-closure echocardiograms on all patients undergoing transcatheter atrial septal defect (ASD) closure with the Bard double-umbrella occluder device aided by simultaneous transesophageal echocardiography to determine precatheterization predictors of outcome. Transesophageal echocardiograms were performed on 28 of 132 patients (22%) undergoing device closure (age = 3-72 years, mean = 14 years; weight = 15-68 kg, mean = 35 kg). Three devices were removed because of unstable position. Of the remaining 25 patients, 21 had effective closure (residual flow diameter < or = 3 mm) and 18 had favorable arm position (device arm on proper side of the septum and not in contact with an atrioventricular valve leaflet). Only ASD size predicted effective closure. All patients with a maximum defect size of < 13 mm had effective closure. Among the 17 patients with defects > or = 13 mm, 10 had effective closure, 4 had significant residual flow, and 3 had devices removed for unstable position. Atrial dimensions and rim size did not predict effective closure. There were no pre-closure predictors of favorable arm position which was associated only with the size of the device implanted.
我们回顾了所有接受经导管房间隔缺损（ASD）封堵术患者的术前超声心动图，这些患者使用巴德双伞封堵器并借助同步经食管超声心动图来确定术前预测预后的因素。132例接受封堵器封堵术的患者中，28例（22%）进行了经食管超声心动图检查（年龄3 - 72岁，平均14岁；体重15 - 68千克，平均35千克）。3个封堵器因位置不稳定被取出。在其余25例患者中，21例实现有效封堵（残余血流直径≤3毫米），18例封堵器臂位置良好（封堵器臂位于房间隔正确一侧且不接触房室瓣叶）。只有房间隔缺损大小可预测有效封堵。所有最大缺损尺寸<13毫米的患者均实现有效封堵。在17例缺损≥13毫米的患者中，10例实现有效封堵，4例有明显残余血流，3例因位置不稳定取出封堵器。心房大小和边缘尺寸不能预测有效封堵。术前没有因素可预测封堵器臂位置良好，该因素仅与植入封堵器的大小有关。
