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Guidance of secundum atrial septal defects occlusion by using transthoracic echocardiography and X-ray fluoroscopy
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 4
- DOI:
- 10.3760/j.issn:1005-1201.2003.04.018
- Key Word:
- 房间隔缺损;超声心动描记术;X线透视检查;放射学,介入性
Abstract： 目的评价在经胸超声心动图(TTE)和X线透视引导下置入Amplatzer封堵器治疗继发孔型房间隔缺损(ASD)的可行性和治疗效果. 方法全组84例,TTE测量ASD最大径:周缘较硬者直接测量ASD最大径;周缘较薄或菲薄的边缘,剔除极软边缘测量ASD最大径.46例同时球囊测量ASD伸展径.均在TTE及透视监视下封堵ASD.结果 84例ASD术前TTE测量缺损最大径为4.0～36.5 mm[(18.7±7.4)mm].TTE测量 ASD最大径(18.6±7.5) mm与球囊伸展径(19.2±7.4)mm差异无显著意义(t=0.384,P>0.05),但两者之间密切相关(r=0.957,P<0.01).84例封堵器置入均获得成功, 选用的封堵器直径为5～40 mm [(22.1±9.7)mm].初期有2例术中同时加做经食管超声心动图(TEE).术后即刻TTE显示6例(7.1%)存在微量至少量残余分流;术后3 d 还有3例(3.6%)存在微量至少量残余分流;术后6个月仅有1例 (1.2%) 多发ASD存在微量分流.39例随访1年以上者右心房、室恢复正常大小,未见封堵器及残余分流者. 结论 TTE和X线引导下经导管置入Amplatzer封堵器治疗ASD是一种有效、安全、简便可行的方法.缺损较大、边缘较短或TTE不易显示清楚的薄缘ASD,术前行TEE检查先了解ASD的边缘,术中可在TTE和透视指导下完成封堵治疗.
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