彩色多普勒超声心动图在室间隔缺损封堵术中的应用价值(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2005年第3期
- 页码:
- 282-284
- 栏目:
- 介入治疗
- 出版日期:
- 2005-05-05
文章信息/Info
- Title:
- Application research of transcatheter closure of ventricular septal defect by color Doppler echocardiography
- Author(s):
- HOU Chuanju; ZHU Xianyang; DENG Dongan; HAN Xiumin; SHENG Xiaotang; CUI Chunsheng ; WANG Qiguang; JIN Yan; ZHANG Po
- Department of Congenital Heart Disease Internal, Shenyang Military General Hospital, Shenyang, Liaoning 110016, China
- 分类号:
- R541.1;R540.45
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨彩色多普勒超声心动图（CDE）在室间隔缺损（VSD）封堵术中应用价值。方法 应用CDE封堵术前选择适应证，术中监视封堵器释放过程，术后判断封堵术疗效，远期随访。结果 应用CDE选择187例VSD，186例封堵成功，1例封堵器术中脱落，成功率99.5%。术后CDE复查发现2例过室间隔少量残余左向右分流。CDE随访3个月发现1例封堵器移位。CDE选择适应证是：①右室面VSD直径≥2 mm，＜10 mm。②VSD边缘距主动脉瓣≥1 mm，轻度以下主动脉瓣关闭不全，无主动脉瓣脱垂。③VSD边缘距三尖瓣隔叶≥2 mm，中度以下三尖瓣关闭不全。④并发能介入治疗的畸形，如动脉导管未闭、继发孔房间隔缺损、卵圆孔未闭和肺动脉瓣狭窄。手术中CDE监测封堵器释放过程是：①心尖四腔心切面确定封堵器导管在左心室内。②胸骨旁五腔心切面确定封堵器位于室间隔的左右心室侧的位置，封堵器中间有室间隔回声。③确定封堵器不影响主动脉瓣和三尖瓣功能。④封堵器到位后彩色多普勒血流显像（CDFI）没有显示或显示微量过室间隔分流束血流信号。封堵术后判断疗效：①封堵器不移位。②CDFI没有显示过室间隔分流束血流信号。③主动脉瓣和三尖瓣功能正常。结论 CDE在VSD封堵术中具有重要临床价值，术前选择适应证，术中监视封堵器释放过程，术后判断封堵术疗效，远期随访，其它检查方法不可能与CDE媲美。
- Abstract:
- AIM To explore the value of color Doppler echocardiography (CDE) on occlusion of ventricular septal defect (VSD). METHODS To select the indication, monitor the procedures delivery, judge the effect and do followup before ,during and after the transcatheter closure of VSD by CDE. RESULTS Selected 186 cases of VSD was successfully occluded and 1 failed because of the device dropt. There were the trivial residual shunt through ventricular septal in 2 cases immediately after the operation and 1 displacement of occluder in the 3month followup. Indications of closure VSD by CDE was: ① Diameter of VSD at the right ventriclar side ≥2 mm, <10 mm. ② Distance from VSD to aortic valve ≥1mm, with regurgition of aortic valve smaller than mild grade and without aortic valve prolapse. ③Distance from VSD to TV≥2mm with regurgition of TV smaller than middle grade. ④ No other abnormality the better; if there was, only patent ductus arteriosus，secondary atrial septal defect, atrial septal patent oval foramen and pulmonary valve stenosis were permitted. The procedure of CDE monitoring during operation was as followed: ① to make sure that the catherter of the occluder was in LV on four chamber view. ② To make sure that the left side of the occluder were close to the LV side of VS and the right side of the occluder to the RV side of VS with detectable echo from middle of the occluder and right location of the occluder. ③ no effect of occluder on the function of AV and TV. ④ No or mild shunt signal were showed on CDFI after mounting of the occluder. Judgement of the curative effect of VSD occlusion: ① No displacement of occluder. ② No shunt signal through VS showed on CDFI. ③ Normal function of AV and TV. CONCLUSION CDE showed more important clinical value on the seletion of indication ,monitoring of the occulder mounting, judgement of the effect and followup after operation of VSD occlusion than any other examine method.
参考文献/References
［1］邓东安,侯传举. 先天性心脏病影像诊断学［M］. 沈阳: 辽宁科学技术出版社,1988.66-70.
［2］朱鲜阳,韩秀敏,全薇,等. 肌部室间隔缺损封堵治疗成功2例［J］. 中国循环杂志,2001,16(2): 97-98.
［3］ Arora R, Trehan V, Thakur AK, et al.Transcatheter closure of congenital muscular ventricular septal defect［J］. J Interv Cardiol， 2004,17(2): 109-115.
［4］孔祥清,曹克将,杨 荣,等.应用Amplatzer封堵器关闭32例膜部室间隔缺损［J］. 中国介入心脏病学杂志,2004,12(1): 21-24.
［5］胡海波,蒋世良,徐仲英,等. 应用新型Amplatzer封堵器治疗膜周部室间隔缺损的初步研究［J］.中华心血管病杂志,2004,32(3): 237-240.
［6］秦永文,赵仙先,吴弘,等. 自制非对称型室间隔缺损封堵器的初步临床应用［J］. 介入放射学杂志, 2004,13(2): 101-103.
［7］马依彤,杨毅宁,汤宝鹏,等. 应用Amplatzer偏心性封堵器介入治疗膜部室间隔缺损［J］.中国介入心脏病学杂志,2003,11(2): 60-62.
［8］李靖,刘延玲,蒋世良,等. 实时三维超声心动图在室间隔缺损封堵中的应用［J］.中华医学超声杂志,2004,1(2): 60-61.
［9］李军,张军,姚志勇,等. 经胸超声心动图在室间隔缺损封堵术中的应用研究［J］.中国超声医学杂志,2003,19(10): 740-743.
［10］田家玮,秦燕,于波,等. 超声心动图在室间隔缺损Amplatzer封堵术中的应用［J］.中华超声影像学杂志,2004,13(1): 20-22.
备注/Memo
- 备注/Memo:
- 收稿日期：2004-12-30.
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更新日期/Last Update: 2010-01-05