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目的 :观察应用Amplatzer封堵器经导管治疗二孔型ASD的疗效 ,并评价经食道超声 (TEE)在介入治疗ASD中的价值。方法 :全组共 1 8例 ,均为二孔型ASD ,年龄 1 4～ 4 1岁 ,平均 2 1 .6岁。TEE测ASD最大直径 3 3mm ,平均 2 1 .4mm ,缺损周边有足够的房间隔空间。在透视及TEE监视下经导管置入Amplatrzer封堵器封堵ASD ,术后即刻、2 4h、3个月分别行TEE检查 ,评价治疗效果。结果 :全组技术成功率为 1 0 0 % ,术后 2 4hTEE检查显示 1 4例ASD完全闭合 ,4例存在微量残余分流 ,术后 3个月均无残余分流 ,无任何并发症。结论 :应用Amplatzer封堵器经导管治疗二孔型ASD操作简便 ,成功率高 ,是目前导管介入治疗ASD的首选治疗器材。TEE在对病例的筛选、引导封堵器的置入及术后疗效评价等方面有极重要的作用。
Objective: To observe the curative effect of transcatheter therapy of two-hole ASD with Amplatzer occluder and to evaluate the value of transesophageal echocardiography (TEE) in the interventional treatment of ASD. Methods: The whole group was 18 cases, all two-hole ASD, aged 14 to 41 years old, with an average of 21.6 years. TEE measured ASD maximum diameter of 3 3mm, an average of 2 1 .4mm, adequate peripheral space defect space. The ASD was occluded with Amplatrzer occluder under fluoroscopy and TEE monitoring. TEE was performed immediately after operation, 24 h and 3 months respectively to evaluate the therapeutic effect. Results: The technical success rate of the whole group was 100%. Twenty-four hours after the TEE examination showed that 14 cases of ASD were completely closed, 4 cases had residual trace shunt, and no residual shunt occurred after 3 months. No complications were found. CONCLUSION: Amplatzer occluder is a simple and convenient method for the treatment of two-hole ASD with high success rate. It is the first choice of treatment for ASD with catheterization. TEE plays a very important role in the screening of cases, guiding the placement of occluders and the evaluation of postoperative efficacy.