应用全 3D 经食管超声心动图精确引导房间隔缺损经皮封堵治疗的可行性研究_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

严富天 ¹ , 李娜 ¹ ,  张本贵 ² , 陈秋林 ² , 何平 ³

1. ;
2. ;
3. ;

Corresponding author：

张本贵, Email: 190113996@qq.com

Keywords：

房间隔缺损; 经皮封堵; 3D超声心动图

DOI：

10.7507/1007-4848.201903002

Video：

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目的探讨应用全 3D 经食管超声心动图（TEE）在精确引导房间隔缺损（ASD）经皮封堵治疗中的应用。方法纳入 2017 年 7 月至 2018 年 6 月间诊断 ASD，并于我院行全 3D-TEE 引导经皮介入封堵患者 17 例，男 4 例、女 13 例，平均年龄（27.1±8.0）岁。手术过程采用全 3D-TEE 引导经皮 ASD 封堵技术。记录手术时间、成功率、3D 超声图像质量、封堵器更换率及手术相关并发症等。结果经 TEE 示房间隔缺损直径（15.8±2.7）mm，3D-TEE 测量房间隔缺损前后径（17.4±2.4）mm，上下径（17.9±5.3）mm，缺损周长折算径（18.0±3.5）mm。手术成功率 100.0%，平均 ASD 封堵器型号（23.1±3.5）mm，无封堵器脱落，明显残余分流，心内结构损伤等严重不良事件，平均导管操作时间（30.7±5.5）min，封堵器换伞率 11.8%（2/17）。15（88.2%）例患者图像佳并采用全 3D-TEE 引导。结论应用全 3D-TEE 精确引导房间隔缺损经皮封堵治疗安全、有效，具有无辐射及引导精准的优势。

Citation： 严富天, 李娜, 张本贵, 陈秋林, 何平. 应用全 3D 经食管超声心动图精确引导房间隔缺损经皮封堵治疗的可行性研究. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1152-1155. doi: 10.7507/1007-4848.201903002 Copy

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3.	刘垚, 温彬, 张凤文, 等. 新型导丝系统在超声引导房间隔缺损封堵术中的应用价值. 中国胸心血管外科临床杂志, 2019, 26(2): 165-168.
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6.	唐红, 张尔永, 解俊敏, 等. 食管超声心动图监测下经胸微创房间隔缺损封堵术. 中国胸心血管外科临床杂志, 2006, 13(5): 349-351.
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9.	Pan XB, Ou-Yang WB, Pang KJ, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol, 2015, 28(4): 390-395.
10.	Chen FL, Hsiung MC, Hsieh KS, et al. Real time three-dimensional transthoracic echocardiography for guiding Amplatzer septal occluder device deployment in patients with atrial septal defect. Echocardiography, 2006, 23(9): 763-770.
11.	Zhu Y, Liu J, Wang L, et al. Preliminary study of the application of transthoracic echocardiography-guided three-dimensional printing for the assessment of structural heart disease. Echocardiography, 2017, 34(12): 1903-1908.
12.	Zhang H, Tang Z, Han Z, et al. Role of real time-three dimensional transesophageal echocardiography in left atrial appendage closure with LACBES_® devices. Exp Ther Med, 2019, 17(2): 1456-1462.

1. Masura J, Gavora P, Formanek A, et al. Transcatheter closure of secundum atrial septal defects using the new self-centering amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn, 1997, 42(4): 388-393.
2. Ewert P, Berger F, Daehnert I, et al. Transcatheter closure of atrial septal defects without fluoroscopy: feasibility of a new method. Circulation, 2000, 101(8): 847-849.
3. 刘垚, 温彬, 张凤文, 等. 新型导丝系统在超声引导房间隔缺损封堵术中的应用价值. 中国胸心血管外科临床杂志, 2019, 26(2): 165-168.
4. 苏肇伉. 先天性心脏病微创手术的发展趋势. 中国胸心血管外科临床杂志, 2005, 12(4): 229-231.
5. Krishnamoorthy KM, Sasikumar D, Bijulal S. Letter to the editor and response: percutaneous closure of atrial septal defects under transthoracic echocardiography without fluoroscopy. J Interv Cardiol, 2016, 29(4): 439-440.
6. 唐红, 张尔永, 解俊敏, 等. 食管超声心动图监测下经胸微创房间隔缺损封堵术. 中国胸心血管外科临床杂志, 2006, 13(5): 349-351.
7. Roberson DA, Cui VW. Three-dimensional transesophageal echocardiography of atrial septal defect device closure. Curr Cardiol Rep, 2014, 16(2): 453.
8. 潘湘斌, 李守军, 胡盛寿, 等. 经胸超声心动图引导房间隔缺损封堵术的可行性. 中华心血管病杂志, 2014, 42(9): 744-747.
9. Pan XB, Ou-Yang WB, Pang KJ, et al. Percutaneous closure of atrial septal defects under transthoracic echocardiography guidance without fluoroscopy or intubation in children. J Interv Cardiol, 2015, 28(4): 390-395.
10. Chen FL, Hsiung MC, Hsieh KS, et al. Real time three-dimensional transthoracic echocardiography for guiding Amplatzer septal occluder device deployment in patients with atrial septal defect. Echocardiography, 2006, 23(9): 763-770.
11. Zhu Y, Liu J, Wang L, et al. Preliminary study of the application of transthoracic echocardiography-guided three-dimensional printing for the assessment of structural heart disease. Echocardiography, 2017, 34(12): 1903-1908.
12. Zhang H, Tang Z, Han Z, et al. Role of real time-three dimensional transesophageal echocardiography in left atrial appendage closure with LACBES_® devices. Exp Ther Med, 2019, 17(2): 1456-1462.

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应用全 3D 经食管超声心动图精确引导房间隔缺损经皮封堵治疗的可行性研究

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