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目的 评价经胸B超 (TTE)指导Amplatzer封堵器治疗成人继发孔型房间隔缺损 (ASD)的价值。方法 30例ASD行Amplatzer封堵术的患者 ,年龄 13～ 6 5岁 ,平均 (32± 15 )岁 ,术前及术中采用TTE指导封堵 ,术后即刻及术后 1个月 ,3个月分别行TTE检查评价治疗效果。结果 2 4例 (80 % )患者术前和术中直接采用TTE指导封堵成功 ,总有效率为 80 % ;5例 (16 7% )患者术前加做食管B超(TEE)选择适应证 ;1例 (3 3% )患者术中加做TEE指导封堵成功。术中未发生任何重要并发症 ,无急症手术病例。术后即刻TTE彩色多普勒显示 2例 (6 7% )存在微 /少量残余分流 ,术后 1月TTE显示30例患者的ASD完全闭合 ,封堵器形态、位置良好 ,未对毗邻结构产生影响 ,且未见封堵器移位及ASD再通。结论 TTE可用于指导大多数ASD患者行经导管Amplatzer封堵器治疗。
Objective To evaluate the value of transthoracic B-ultrasonography (TTE) -induced Amplatzer occluder in the treatment of adult secondary atrial septal defect (ASD). Methods Thirty ASD patients undergoing Amplatzer occlusion were enrolled in this study. The patients were aged 13 to 65 years (mean, 32 ± 15) years. TTE was used before and during the operation to block the occlusion. Immediately after operation and 1 month after operation, 3 Month TTE examination were performed to evaluate the effect of treatment. Results Twenty-four patients (80%) were successfully treated with TTE before and immediately after operation. The total effective rate was 80%. Five patients (16.7%) underwent preoperative esophageal B-ultrasound (TEE) ; 1 case (33%) of patients with TEE guidance to do a successful operation. No major complications during surgery, no emergency surgery cases. Immediate postoperative TTE color Doppler showed slight residual flow in 2 cases (67%). At 1 month after operation, the TTE of 30 patients was completely closed and the morphology and location of the occluder were intact. The adjacent structures were not found Affect, and no occluder displacement and ASD recanalization. Conclusion TTE can be used to guide the treatment of most ASD patients with catheter Amplatzer occluder.