CAJ | 학술논문

目的探讨经食管超声心动图(TEE)指导、监测偏心型封堵器在经胸微创行嵴内型室间隔缺损(VSD)镶嵌术中的应用价值.方法回顾性分析我院利用偏心型封堵器行微创镶嵌术成功治疗的13例嵴内型VSD患儿,术前所有患儿均行经胸超声心动图详细筛查,无明显主动脉瓣脱垂及中度以上反流,术中TEE指导、监测整个封堵过程,评价即刻封堵效果.结果 13例微创镶嵌术全部成功.术后即刻TEE显示封堵器与VSD边缘吻合紧密,主动脉瓣反流无加重,2例封堵器边缘存在细小左向右分流(分流束＜1.5 mm).所有患儿术后随访6个月～2年,均见封堵器位置正常,未出现严重并发症.原有2例残余分流分别于术后第1月和第3月复查消失.结论在TEE指导和监测下,偏心型封堵器微创镶嵌术治疗嵴内型VSD操作简单,创伤小,安全性高,近期疗效满意.
목적 탐토경식관초성심동도(TEE)지도、감측편심형봉도기재경흉미창행척내형실간격결손(VSD)양감술중적응용개치.방법 회고성분석아원이용편심형봉도기행미창양감술성공치료적13례척내형VSD환인,술전소유환인균행경흉초성심동도상세사사,무명현주동맥판탈수급중도이상반류,술중TEE지도、감측정개봉도과정,평개즉각봉도효과.결과 13례미창양감술전부성공.술후즉각TEE현시봉도기여VSD변연문합긴밀,주동맥판반류무가중,2례봉도기변연존재세소좌향우분류(분류속＜1.5 mm).소유환인술후수방6개월～2년,균견봉도기위치정상,미출현엄중병발증.원유2례잔여분류분별우술후제1월화제3월복사소실.결론 재TEE지도화감측하,편심형봉도기미창양감술치료척내형VSD조작간단,창상소,안전성고,근기료효만의.
Objective To evaluate the clinical outcome of transesophageal echocardiography(TEE) in guiding and monitoring min-invasive transthoracic hybrid procedure for intracristal ventricular septal defects (VSD) using eccentric occluders.Methods 13 patients with intacristal VSD successfully underwent the min-invasive hybrid procedure using eccentric occluders were analyzed retrospectively.They were all carefully examined by transthoracic echocardiography (TTE) preoperatively and were diagnosed as intracristal VSD.There were no obvious aortic valve prolapse and no severe regurgitation.The entire process was guided and monitored by TEE.The condition of VSD occlusion was assessed by immediate postoperative TEE.Results All cases were occluded successfully.The results of postoperative TEE showed that the occluder was coincided closely with the edge of VSD,no aortic valve regurgitation worsen.2 had tiny residual left-to-right shunt (＜1.5 mm),which disappeared 1 and 3 months respectively after operation.No occluder dislocated followed-up at 6 months to 2 years postoperatively,and no major complications occurred.Conclusions The min-invasive hybrid procedure for intracristal VSD using eccentric occluders guided and monitored by TEE is easy to manipulate,which is safe,less invasive,and has excellent early-term results.