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目的应用经胸及经食管超声评价左心耳封堵术前、术中左心耳形态及血流动力学及术后随访的意义。方法 23例心房颤动患者分别于术前、术中、术后采用经胸及经食管超声测量左房及左室内径、左室射血分数、二尖瓣反流容积、二尖瓣口舒张期血流速度(E峰)、左心耳入口直径、腰部直径及长径、左上肺静脉血流速度,并在术中监测引导房间隔穿刺、实时观察封堵器的位置。结果 23例患者均成功植入封堵器,仅有3例出现封堵器周围残余分流,但宽度均<5 mm。术前、术中、术后相比,左房、左室内径、左室射血分数、二尖瓣反流容积、二尖瓣舒张期血流速度、左上肺静脉血流速度之间差异均无统计学意义(P>0.05)。经食管超声测得左心耳腰部及入口处直径对于封堵器规格的选择有重要参考价值。结论经食管超声在围左心耳封堵术期的应用具有重要临床意义,左心耳封堵术安全有效。
Objective To evaluate the morphology, hemodynamics and postoperative follow-up of left atrial appendage before transthoracic transesophageal echocardiography and transesophageal echocardiography. Methods Twenty-three patients with atrial fibrillation underwent transthoracic and transesophageal echocardiography. The left atrium and left ventricular internal diameter, left ventricular ejection fraction, mitral regurgitation volume, mitral valve diastolic phase Blood flow velocity (E peak), left atrial appendage diameter, lumbar diameter and long diameter, left upper pulmonary vein blood flow velocity, and intraoperative monitoring and guidance of atrial septal puncture, real-time observation occluder position. Results All 23 patients were successfully implanted occluders, and only 3 patients had residual shunt around the occluder but the widths were less than 5 mm. There was no significant difference in left atrium, left ventricular diameter, left ventricular ejection fraction, mitral regurgitation volume, mitral diastolic flow velocity and left superior pulmonary vein flow velocity before, during and after surgery Statistical significance (P> 0.05). Trans-esophageal ultrasound measured the diameter of the left atrium lumbar and entrance for the selection of occluder specifications have important reference value. Conclusion The application of transesophageal echocardiography in the perioperative closure of atrial appendage has an important clinical significance. The closure of the left atrial appendage is safe and effective.