應用全 3D 經食管超聲心動圖精確引導房間隔缺損經皮封堵治療的可行性研究_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

嚴富天 ¹ , 李娜 ¹ ,  張本貴 ² , 陳秋林 ² , 何平 ³

1. ;
2. ;
3. ;

Corresponding?author：

張本貴, Email: 190113996@qq.com

Keywords：

房間隔缺損; 經皮封堵; 3D超聲心動圖

DOI：

10.7507/1007-4848.201903002

Video：

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目的探討應用全 3D 經食管超聲心動圖（TEE）在精確引導房間隔缺損（ASD）經皮封堵治療中的應用。方法納入 2017 年 7 月至 2018 年 6 月間診斷 ASD，并于我院行全 3D-TEE 引導經皮介入封堵患者 17 例，男 4 例、女 13 例，平均年齡（27.1±8.0）歲。手術過程采用全 3D-TEE 引導經皮 ASD 封堵技術。記錄手術時間、成功率、3D 超聲圖像質量、封堵器更換率及手術相關并發癥等。結果經 TEE 示房間隔缺損直徑（15.8±2.7）mm，3D-TEE 測量房間隔缺損前后徑（17.4±2.4）mm，上下徑（17.9±5.3）mm，缺損周長折算徑（18.0±3.5）mm。手術成功率 100.0%，平均 ASD 封堵器型號（23.1±3.5）mm，無封堵器脫落，明顯殘余分流，心內結構損傷等嚴重不良事件，平均導管操作時間（30.7±5.5）min，封堵器換傘率 11.8%（2/17）。15（88.2%）例患者圖像佳并采用全 3D-TEE 引導。結論應用全 3D-TEE 精確引導房間隔缺損經皮封堵治療安全、有效，具有無輻射及引導精準的優勢。

Citation： 嚴富天, 李娜, 張本貴, 陳秋林, 何平. 應用全 3D 經食管超聲心動圖精確引導房間隔缺損經皮封堵治療的可行性研究. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1152-1155. doi: 10.7507/1007-4848.201903002 Copy

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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.	劉垚, 溫彬, 張鳳文, 等. 新型導絲系統在超聲引導房間隔缺損封堵術中的應用價值. 中國胸心血管外科臨床雜志, 2019, 26(2): 165-168.
4.	蘇肇伉. 先天性心臟病微創手術的發展趨勢. 中國胸心血管外科臨床雜志, 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.	唐紅, 張爾永, 解俊敏, 等. 食管超聲心動圖監測下經胸微創房間隔缺損封堵術. 中國胸心血管外科臨床雜志, 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, 李守軍, 胡盛壽, 等. 經胸超聲心動圖引導房間隔缺損封堵術的可行性. 中華心血管病雜志, 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.

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. 劉垚, 溫彬, 張鳳文, 等. 新型導絲系統在超聲引導房間隔缺損封堵術中的應用價值. 中國胸心血管外科臨床雜志, 2019, 26(2): 165-168.
4. 蘇肇伉. 先天性心臟病微創手術的發展趨勢. 中國胸心血管外科臨床雜志, 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. 唐紅, 張爾永, 解俊敏, 等. 食管超聲心動圖監測下經胸微創房間隔缺損封堵術. 中國胸心血管外科臨床雜志, 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, 李守軍, 胡盛壽, 等. 經胸超聲心動圖引導房間隔缺損封堵術的可行性. 中華心血管病雜志, 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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應用全 3D 經食管超聲心動圖精確引導房間隔缺損經皮封堵治療的可行性研究

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