经胸超声心动图引导置入Amplatzer封堵器治疗二孔型房间隔缺损Transcatfaeter closure of secundum atrial septal defects using Amplatzer septal occluder with guidance of transthoracic echocardiography: A preliminary result of clinical application
徐立,戴汝平,刘延玲,徐仲英,张戈军,朱振辉,唐红伟,蒋世良
摘要(Abstract):
目的 经胸超声心动图(TFE)监测下经导管置入Amplatzer封堵器治疗二孔型房间隔缺损(ASD),并对其近期疗效进行初步评价。方法33例患者,男性15例,女性18例,年龄3~17(8.7±4.0)岁,体重12.5~53(28.2±12.1)kg,单发ASD 32例,多发1例。所有病例均于X线透视和TTE监测下置入Amplatzer封堵器闭合ASD。术后重复TTE、ECG及X线平片检查。结果 术中TTE所测缺损大小为6~23(13.7±4.2)mm,采用封堵器直径为10~26(17.2±4.4)mm。33例封堵器置入均获成功,技术成功率为100%,术中2例发生一过性ST段抬高,并自行恢复,无急诊手术和死亡病例。术后即刻TTE显示3例(9.1%)存在残余分流,2例微量残余分流于术后24h消失,另1例为多发ASD患者,术后24h及5周随访提示残余分流仍存。结论 在合适患者中,TTE监测下经导管置入Amplatzer封堵器治疗二孔型ASD是一种安全有效的方法,在该部分患者中可以代替经食管超声心动图(TEE),但在应用过程中必须严格强调适应证的筛选。
关键词(KeyWords): 房间隔缺损;心导管术;心动描记术;Amplatzer封堵器
基金项目(Foundation):
作者(Author): 徐立,戴汝平,刘延玲,徐仲英,张戈军,朱振辉,唐红伟,蒋世良
参考文献(References):
- 1 Hellenbrand WE, Fahey JT, McGowan FX, et al. Transesophageal echocardiographic guidance of transcatheter closure of atrial septal defect. Am J Cardiol, 1990,66:207-213.
- 2 戴汝平,刘延玲,张戈军,等.应用Amplatzer封堵器介入治疗房 间隔缺损疗效评价(附60例报告).中华心血管病杂志,2000, 28:87-92.
- 3 Daniel WG, Erbel R, Rasper W, et al. Safety of transesophageal echocardiography: a multicenter survey of 10, 419 examinations. Circulation, 1991,83:817-821.
- 4 Khandheria BK., Seward JB. , Tajik AJ. Concise review for primary-care physicians: transesophageal echocardiography. Mayo Clin Proc, 1994,69:856-863.
- 5 Feltes TF. Advances in transesophageal echocardiography: impact of a changing technology on children with congenital heart disease. J Am CollCardiol, 1991,18:1515-1516.