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目的 :评价经胸超声心动图 (TTE)术前测量房间隔缺损 (ASD)大小及术中监测 ASD封堵的作用。方法 :60例 ASD患者 ,年龄 1 .1 7～ 65 (2 5.0± 1 8.6)岁。术前用 HP Sonos1 50 0及 550 0型彩色多普勒超声诊断仪经胸测量各切面 ASD大小及周缘情况 ,经心导管 ASD封堵术中 TTE监测封堵过程、伞释出后牢固程度及彩色多普勒有无分流。结果 :用 TTE术前检查 ASD大小 2～ 36 (1 7.8± 7.3) mm,选用 ASD封堵器大小为 5～ 40 (2 2 .9±8.0 ) mm。超声测量 ASD大小与封堵器大小相关良好 ,r=0 .94(P<0 .0 0 1 )。硬缘 ASD的封堵器选择比超声所测ASD大 1～ 6mm。软缘 ASD通常不考虑摆动较大部分为有效缘而予以去除 ,封堵器选择比超声所测 ASD大 7～1 3mm不等。所有封堵器封堵牢固 ,无脱落。结论 :TTE术前检查及术中指导 ASD封堵是一种可行、有效、简便的方法。缺损较大、边缘较短或 TTE不易显示清楚的薄缘 ASD应进行术中经食道超声监测
Objective: To evaluate the effect of transthoracic echocardiography (TTE) on the measurement of atrial septal defect (ASD) and intraoperative monitoring of ASD occlusion. Methods: Sixty ASD patients aged from 1.17 to 65 (2 5.0 ± 1.86) years old. Preoperative AS Sonos1 50 0 and 550 0 color Doppler ultrasound diagnostic instrument through the thoracic ASD size and peripheral edge of each section, transcatheter closure of cardiac catheterization TTE ASD monitoring of the occlusion process, the release of solid firmness and Color Doppler with or without shunt. Results: The ASD size was 2 ~ 36 (1 7.8 ± 7.3) mm preoperatively and the ASD occluder size was 5 ~ 40 (22.9 ± 8.0) mm. The size of ASD measured by ultrasound was well correlated with occluder size, r = 0.94 (P <0.001). The choice of occluder for hard ASD is 1 ~ 6mm larger than the ASD measured by ultrasound. Soft-rim ASD usually do not consider the greater part of the swing for the effective edge and be removed, occluder selection than the ASD measured by ultrasound 7 ~ 13mm range. All occluder tightly closed, no shedding. Conclusion: TTE preoperative examination and intraoperative guidance of ASD occlusion is a feasible, effective and simple method. A large margin of the defect, the edge is short or the TTE is not easy to show a clear edge of the ASD should be performed intraoperative transesophageal ultrasound