论文部分内容阅读
目的探讨房间隔缺损经Amplatzer封堵器封堵术后左心形态和血流动力学的变化。方法65例继发孔型房间隔缺损患者,45例3个月后进行了随访。经胸超声心动图检查分别于术前、术后48~72 h及3个月后进行,测量缺损大小、左室前后径、横径、二尖瓣及主动脉瓣瓣口血流脉冲及组织多普勒流速曲线的相关参数,计算Tei指数和TeiTDI指数。结果房间隔缺损平均孔径(2.5±0.3)cm,舒张末期左室前后径于术后早期和中期扩大,横径于中期扩大,每搏输出量和射血分数迅即持续增加;代偿增强的左室后壁运动幅度恢复。术后早期和中期左室收缩期血流峰值速度均较术前增快,但射血时间无明显延长,术后中期左室血流充盈时间延长。心率、Tei指数及TeiTDI指数封堵术前后无明显变化。结论房间隔缺损封堵术纠正了解剖畸形,使左、右心室的前后负荷回复正常,左心室的解剖构型、舒张和收缩功能迅速得到纠正,血流动力学快速改善,前负荷的变化对心率无影响。
Objective To investigate the change of left ventricular morphology and hemodynamics after atrial septal defect closure with Amplatzer occluder. Methods Sixty-five patients with atrial septal defect and 45 cases were followed up 3 months later. Transthoracic echocardiography was performed preoperatively and postoperatively at 48-72 h and 3 months postoperatively. The size of the defect, the anteroposterior diameter of the left ventricle, the transverse diameter, the pulse of the mitral and aortic valves, Doppler flow curve of the relevant parameters, calculated Tei index and TeiTDI index. Results The mean atrial diameter of atrial septal defect was (2.5 ± 0.3) cm. The anteroposterior diameter of left ventricular end-diastole was increased in the early and mid-postoperative period. The transverse diameter increased at the mid-term and the stroke volume and ejection fraction increased continuously. Back wall motion amplitude recovery. The peak velocity of systolic velocity of left ventricular systolic velocity in early and middle period after operation was faster than that of preoperation, but the ejection time was not significantly prolonged and the left ventricular filling time was longer in the middle of postoperative period. Heart rate, Tei index and TeiTDI index closure before and after no significant change. Conclusions Atrial septal defect occlusion corrected the anatomical deformity and normalized left and right ventricular anterior and posterior load. The left ventricular anatomy, diastolic and systolic function were corrected rapidly, hemodynamics improved rapidly and the change of pre-load No effect on heart rate.