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目的评价应用经胸超声和X线指引下行成人房间隔瘤合并缺损的封堵治疗的疗效和安全性。方法 20例成人患者,男4例,女16例,年龄(39.0±11.4)岁;术前经胸超声,部分患者同时行食道超声检查诊断为房间隔瘤合并继发孔房间隔缺损,房间隔瘤基底部宽度11～38mm,平均(21.7±7.7)mm,膨出深度7～11mm,平均(9.1±1.8)mm。合并单孔缺损14例,多孔缺损6例,彩色多普勒显示均为左向右分流。介入术中采用经胸超声和X线指引。术后随访采用经胸超声观察心脏大小、封堵器位置。结果房间隔缺损的直径为7～28mm,平均(15.4±5.7)mm。所有患者均封堵成功,共置入国产房间隔缺损专用封堵器20枚,封堵器直径16～36mm,平均(25.0±5.7)mm。随访3～12个月,所有患者封堵器位置固定,无残余分流。14例患者(70%)心脏大小恢复正常。结论经胸超声心动图结合X线可安全、有效的指引成人房间隔瘤并缺损患者的介入封堵治疗,但影像表现有其特殊性。
Objective To evaluate the efficacy and safety of transthoracic echocardiography and X-ray in the treatment of adult atrial septal defect with occlusion. Methods Twenty adult patients, including 4 males and 16 females, were aged (39.0 ± 11.4) years. Preoperative transthoracic echocardiography was performed in some patients with simultaneous diagnosis of atrial septal and secondary atrial septal defect with atrial septal defect The width of tumor base was 11 ~ 38 mm, with an average of (21.7 ± 7.7) mm and bulging depth of 7 ~ 11 mm, with an average of (9.1 ± 1.8) mm. 14 cases complicated with single-hole defect, 6 cases of porous defect, color Doppler showed left to right shunt. Interventional use of transthoracic ultrasound and X-ray guidelines. Postoperative follow-up observation by transthoracic heart size, occluder position. Results Atrial septal defect diameter of 7 ~ 28mm, with an average (15.4 ± 5.7) mm. All patients were successfully blocked, a total of 20 domestic atrial septal defect occluders were placed, occluder diameter 16 ~ 36mm, with an average (25.0 ± 5.7) mm. All cases were followed up for 3 to 12 months. All patients had a fixed occluder without residual shunt. Fourteen patients (70%) returned to normal heart size. Conclusion Transthoracic echocardiography combined with X-ray can safely and effectively guide the interventional closure of adult patients with atrial septal defects and defects. However, the imaging features are special.