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目的 :评价房间隔缺损 (ASD)患者在经导管 Amplatzer伞封堵治疗术后的疗效及随访中左、右心功能及血流动力学的变化。方法 :2 6例继发孔型房间隔缺损患者术前经食管超声心动图 (TEE)检查示 ASD直径平均为 2 0 .4 9mm± 6 .2 7mm (7.5 mm~ 34mm )。所有病例均在透视及经胸和 /或经食管超声心动图 (TEE)监视下经导管置入 Amplatzer封堵器封堵 ASD。在经胸或经食管超声心动图监测下行 Amplatzer闭合器封堵房间隔缺损。术后 2 4~ 4 8小时、 1个月、 3个月及 1年分别行经胸超声心动图 (TTE)检查 ,测量左、右室及右房大小、肺动脉内径及肺动脉压、左室每搏量及左室射血分数、左室偏心率 ,评价治疗效果。结果 :ASD Amplatzer伞封堵术后 ,左室内径增大 ,左室每搏量、左室射血分数增高。右室、右房及肺动脉内径缩小 ,肺动脉压明显下降 ,92 .3%恢复正常 ,左室偏心率变小 ,心脏重构在随访中持续逆转 ,心脏血流动力学明显改变。结论 :ASD封堵治疗既减轻了右心负荷 ,也改善了左室收缩功能 ,并且逆转了心脏重构 ,血流动力学明显改善 ,术后三月时大多数患者可恢复到正常水平
OBJECTIVE: To evaluate the efficacy and duration of left and right heart function and hemodynamic changes in patients with atrial septal defect (ASD) after transcatheter Amplatzer occlusion. Methods: Preoperative esophageal echocardiography (TEE) was performed in 26 patients with atrial septal defect. The mean ASD diameter was 20.49mm ± 6.27mm (7.5mm-34mm). All patients underwent transcatheter closure of the ASD with Amplatzer occluder under fluoroscopy and transthoracic and / or transesophageal echocardiography (TEE). Transeptal or transesophageal echocardiography was performed to detect Amplatzer closure of atrial septal defect. Twenty-four to 48-hour, 1 month, 3-month and 1-year postoperative examinations were performed by transthoracic echocardiography (TTE). Left and right ventricles, right atrium size, pulmonary artery diameter and pulmonary artery pressure were measured. Left ventricular stroke Volume and left ventricular ejection fraction, left ventricular eccentricity, evaluate the therapeutic effect. Results: After ASD Amplatzer occlusion, left ventricular diameter increased, left ventricular stroke volume and left ventricular ejection fraction increased. Right ventricle, right atrium and pulmonary artery diameter decreased, pulmonary artery pressure decreased significantly, 92.3% returned to normal, left ventricular eccentricity decreased, cardiac remodeling continued to reverse at follow-up, cardiac hemodynamics significantly changed. CONCLUSIONS: ASD occlusion treatment not only relieved right heart load but also improved left ventricular systolic function and reversed cardiac remodeling with significantly improved hemodynamics, with most patients recovering to normal levels after three months