摘要
目的:研究超声心动图在嵴内型室间隔缺损(VSD)封堵中的作用,并与X线左室造影结果比较。方法:入选病例包括嵴内型VSD患者13例。二维超声心动图及彩色多普勒血流图于胸骨旁左室长轴、大血管短轴及心尖五腔观测量缺损大小及其距主动脉右冠瓣、肺动脉瓣及三尖瓣的距离;术中行X线左室造影观测缺损口大小、距主动脉右冠瓣距离。封堵器释放后测量其腰部的直径。结果:二维超声心动图与彩色多普勒血流图除2例部分切面难以判断缺损口大小外,其余病例均显示缺损口大小及距各瓣的距离,大部分病例超声术前测量的缺损口大小与释放后封堵器的腰径相似。X线左室造影5例因造影角度不佳无法显示分流口大小,仅显示右室内存在分流;显示分流口的病例中部分明显小于释放后封堵器腰径。本组病例中1例封堵后出现少量主动脉瓣返流,1例术后出现封堵器移位,并出现残余分流。结论:超声心动图对嵴内型VSD封堵的术前选择优于X线左室造影。适合于嵴内型VSD封堵的患者缺损口不宜大于8mm,并无主动脉瓣脱垂。如缺损口过大可能出现术后主动脉瓣返流或封堵器移位。
AIM:To study the function on occlusion of intercristal ventricular septal defect(VSD) and compare with the result of left ventricular angiography. METHODS: Thirteen patients with intercristal VSD were studied by measuring defect size and its distance to aortic, pulmonary and tricuspid valves with echocardiography and measuring defect size and its distance to aortic valve with left ventricular angiography of X ray. After releasing occluder, the size of its waist was measured. RESULTS: The defect size and its distance to valves could clearly showed by echocardiography except for those in part views of 2 cases. The defect size measured with echocardiography in the most cases before occlusion was similar with the waist size of released occluder. In 5 cases, the ventricular defect shunt could be seen in right ventricle but shunt orifice could not be showed because of improper angle of angiography, while the shunt orifice in part of cases showed with angiography was much more smaller than the waist size of released occluder. A little aortic regurgitation was found in one case and the displacement of occluder with residual shunt was found in another case after occlusion in this group. CONCLUSION: Echocardiography is better than angiography on occlusion selection of intercristal VSD. The VSD size should not be larger than 8 mm usually and without aortic regurgitation for intercristal VSD occlusion. Big intercristal VSD might occur aortic regurgitation and occluder displacement after occlusion.
出处
《心脏杂志》
CAS
2005年第3期275-278,共4页
Chinese Heart Journal
关键词
室间隔缺损
封堵
超声心动图
ventricular septal defect
occlusion
echocardiography
