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超声心动图在Amplatzer 法介入治疗动脉导管未闭中作用的评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第3期
页码:
247-249
栏目:
先心病介入治疗
出版日期:
2002-05-01

文章信息/Info

Title:
Evaluation of transthoracic echocardiography in transcatheter closure of PDA using Amplatzer device
作者:
王树祥;  张玉顺;  代政学;  李　寰
第四军医大学西京医院心脏内科, 陕西 西安 710032
Author(s):
WANG Shu-xiang ;  ZHANG Yu-shun;  DAI Zheng-xue; LI Huan
1.Department of Cardiology Xijing Hospital, Fourth Military Medical University, Xi′an 710032, Shaanxi, China
关键词:
动脉导管未闭;  超声心动图描记术;  经胸;  血管造影术
Keywords:
ductus arteriosus;  patent;  echocardiography;  transthoracic;  angiography
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 分析未闭动脉导管(PDA) 经超声心动图和X 线造影测量的最窄处直径大小和形态的关系, 探讨超声心动图在Amplatzer 法介入治疗PDA中的作用。方法 全组36 例, 年龄1.5～ 46 (12±14) 岁。均采用Amp latzer 法进行介入治疗。术前行超声心动图检查测量PDA 直径和形态, 术中通过主动脉弓降部造影再测量PDA 直径、观察其形态。将两者的测量值加以对比。结果 36 例患者的PDA 最窄处直径超声心动图测量为5.4±1.8mm , 主动脉弓降部造影测量为5.1±1.9mm , 两者无显著差异(P > 0. 05) ; 超声心动图显示PDA 属漏斗型27 例, 管型9 例; 造影显示PDA 属Krichenko A 型29 例,B 型4 例和C 型3 例, 其中超声检查管型中, 造影示有2 例漏斗型(A 型) , 余7 例分别为B 型和C 型。36 例全部封堵成功, 术后即刻造影6 例(17% ) 有微量残余分流; 术后3 d 超声心动图复查, 6 例微量残余分流均消失, 左心腔内径均明显回缩(P < 0. 01) , 左室射血分数降低。结论 超声心动图在PDA 介入治疗术前筛选患者、选择方法、判断PDA 的直径大小, 术后疗效的评价方面具有重要的作用。
Abstract:
AIM To analysize the compatibility of the narrowest patent ductus arteriosus(PDA) diameter and shape measured by transthoracic echocardiography(TTE) and angiography and to find the role of TTE in the transcatheter closure of PDA.METHODS: There were 36 patients with the age of 12±14 years (ranging from 1.5 to 46 years). TTE was performed to confirm the location, shape and the narrowest diameter of PDA in every case before transcatheter closure of PDA using Amplatzer duct occluder (ADO). A lateral descending aortogram was performed to evaluate the size, position and shape of the ductus during the procedure. The results were analysized by t-test.RESULTS: The mean sonographic diameter of PDA was 5.4±1.8 mm, aortography showed the mean value of the narrowest diameter was 5.1±1.9 mm(P>0.05). The types of PDA with TTE were divided into funel type in 27, tube type in 9. According to the classification adopted by Krichento 29 patients had PDA of type A, 4 of type B and 3 of type C.Aortography showed that 2 cases had PDA of type A and the remaining 7 cases had type B and C in 9 cases of tube type measured by TTE. All patients had successful placement. Angiography showed that 6 cases had a trace shunt immediately after the procedure.Color Doppler revealed 3d after the procedure that trace shunt disappeared in 6 patients,the inner diameter of left heart decreased significantly and left ventricular ejection fraction lowered.CONCLUSION: TTE plays an important role in patient selection before transcather closure of PDA and in which transcatheter method to decide. It also had a role in measuring the narrowest diameter of PDA and in the PDA follow-up study.

参考文献/References

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[5] Krichenko A, Benson LN, Burrows P,et al. Angiographic classification of the isolated, persistently patent ductus arteriosus and implications for percutaneous catheter occlusion[J].Am J Cardiol, 1989,63:877-880.

[6] Rao PS. Transcatheter occlusion of patent ductus arteriosus which method to use and which ductus to close[J].Am Heart J,1996,132:905-909.

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张玉顺,代政学,贾国良,等.应用Amplatzer封堵器经导管治疗直径≥8 mm动脉导管未闭的疗效评价[J].心脏杂志,2001,13(3):204-208.

备注/Memo

备注/Memo:
收稿日期：2001-11-01.现在武警8640 部队医院, 河北 定州 073000
更新日期/Last Update: 2005-05-01