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目的 探讨Amplatzer房间隔缺损封堵器 (ASO)置入人体后形态的变化及其可能的影响。方法 全组共 34例房间隔缺损患者 ,按常规方法置入ASO ,于术后 2 4～ 4 8h、3个月及 1年以计算机X线摄影系统 (CR)进行X线平片检查。选择左侧位片 ,以CR自带测量系统测量封堵器左、右房盘状结构中心的不透X线的金属标记的间距 (D1)、封堵器左、右房盘状结构的直径 (D2、D3)。同时 ,患者亦行经胸超声心动图 (TTE)检查 ,以评价封堵效果及封堵器对毗邻结构的影响。结果 34例封堵器置入均获得成功。本组病例ASD直径为 (2 0 0 9± 6 0 0 )mm(6～ 2 9mm) ,选择的封堵器直径为(2 3 97± 5 93)mm(10～ 34mm)。 34例均完成了术后 2 4～ 4 8h及术后 3个月的随访 ,10例完成了术后1年的随访。术后 3个月D1较术后 2 4～ 4 8h缩小 ,提示封堵器厚度变薄 ,D2及D3则无明显改变 ;术后 1年D1较术后 3个月进一步缩小 ,提示封堵器厚度继续减小 ,而D2及D3未见显著改变。D1与封堵器的直径呈部分相关。随访中TTE示ASD均完全闭合 ,未见残余分流 ;ASD毗邻结构未见受到封堵器形态变化的影响。结论 应用X线平片及TTE可对Amplatzer房间隔缺损封堵器置入体内后的形态进行无创性观察。封堵器的厚度与其直径部分相关 ,在随访中厚度逐渐减小 ,几何?
Objective To investigate the morphological changes of Amplatzer atrial septal defect occluder (ASO) and their possible effects. Methods A total of 34 patients with atrial septal defect were enrolled in this study. ASO was routinely performed. X-ray examination was performed by computerized radiography (CR) at 24 to 48 hours, 3 months and 1 year after operation. Select the left flaps to measure the diameter of the radiopaque metal markers (D1) in the center of the left and right disc-shaped structures of the occluder with CR’s own measurement system, (D2, D3). At the same time, the patient underwent transthoracic echocardiography (TTE) to evaluate the effect of occlusion and the effect of occluder on the adjacent structures. Results 34 cases of occluder placement were successful. The diameter of ASD in this group was (260 ± 6 0 0) mm (6 ~ 29mm), and the diameter of the occluder selected was (2397 ± 5 93) mm (10 ~ 34mm). All 34 cases were followed up from 24 to 48 hours and 3 months after operation, and 10 cases completed one year follow-up. D1 at 3 months after operation was smaller than that at 24-48 h after operation, suggesting that the thickness of the occluder was thinner and D2 and D3 had no significant changes. D1 at 1 year after operation was further reduced 3 months after operation, suggesting that the occluder Thickness continued to decrease, while D2 and D3 showed no significant changes. D1 is partially related to the occluder diameter. During follow-up, TTE showed complete closure of ASD, no residual shunt; ASD adjacent structures were not affected by occluder morphology changes. Conclusion X-ray and TTE can be non-invasive observation of the morphology of Amplatzer atrial septal defect occluder. The thickness of the occluder is related to the diameter of the occluder. At the follow-up, the thickness gradually decreases and the geometry?