经食管超声心动图在心房颤动行左心耳封堵术中的应用Real-time application of two-dimensional and three-dimensional transesophageal echocardiography in left atrial appendage closure in patients with atrial fibrillation
潘翠珍,周达新,张晓春,孔德红,姚豪华,陈永乐,李伟,舒先红,葛均波
摘要(Abstract):
目的初步探讨经食管二维、三维超声心动图(2D TEE、3D TEE)在左心耳封堵术中的应用价值。方法对38例非瓣膜性病变心房颤动(房颤)患者行左心耳封堵,其中男性27例,女性11例,年龄53~85(67.40±7.33)岁。术前均行常规经胸超声心动图(TTE)、2D TEE、3D TEE检查、术中2D TEE、3D TEE监测,术后1个月TEE随访。结果 2D TEE测得的左心耳最大入口处内径[(22.10±2.45)mm比(22.95±2.65)mm,P=0.154]、左心耳长度[(26.39±4.07)mm比(26.73±3.89)mm,P=0.154]与术中数字减影血管造影(DSA)测得的值比较,差异均无统计学意义,但具有很强的相关性[分别为r=0.80,P<0.001,组内的相关系数(ICC)=0.89(0.78~0.94);r=0.88,P<0.001,ICC=0.94(0.88~0.96)]。3D TEE测得的左心耳最大入口处内径[(22.86±2.69)mm比(22.95±2.65)mm,P=0.89]、左心耳长度[(26.73±4.34)mm比(26.73±3.89)mm,P=0.154]与术中DSA测得的值比较,差异均无统计学意义,但具有很强的相关性[分别为r=0.92,P<0.001,ICC=0.96(0.92~0.98);r=0.94,P<0.001,ICC=0.96(0.94~0.98)]。结论 2D TEE、3D TEE均能快速、精确地评价左心耳最大入口处内径及左心耳长度。可作为封堵器型号选择的重要参考标准。
关键词(KeyWords): 心房颤动;左心耳封堵;经食管超声心动图
基金项目(Foundation): 上海市科学技术委员会资助项目(18ZR1436100、16441908100、16441901502)
作者(Author): 潘翠珍,周达新,张晓春,孔德红,姚豪华,陈永乐,李伟,舒先红,葛均波
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