CAJ | 학술논문

目的探讨超声心动图在筛选Ⅱ孔型房间隔缺损（ASD）病例并引导Amplatzer封堵伞介入方法关闭ASD中的应用价值。方法应用经食管超声心动图（TEE）按Amplatzer封堵法适应证条件筛选7例Ⅱ孔型ASD，经胸超声心动图（TTE）及X线引导进行Amplatzer封堵术。结果 1例患者因ASD最大伸展径大于34 mm，无相应的封堵伞而放弃封堵术，另1例患者因ASD缺损口距右房顶距离小于3 mm，置入Amplatzer封堵伞未能封堵成功，放弃手术治疗，余5例成功进行了Amplatzer封堵术。所有病例TEE测量的ASD直径显著小于ASD最大伸展径［（17.2±1.9）mm vs （26.8±1.3）mm］，5例成功病例术后即刻、24 h、1个月、3个月行TTE检查，术后无残余分流，术中、术后无并发症。结论超声心动图在Ⅱ孔型房间隔缺损介入治疗中占有极为重要、不可替代的地位。
목적탐토초성심동도재사선Ⅱ공형방간격결손（ASD）병례병인도Amplatzer봉도산개입방법관폐ASD중적응용개치。방법응용경식관초성심동도（TEE）안Amplatzer봉도법괄응증조건사선7례Ⅱ공형ASD，경흉초성심동도（TTE）급X선인도진행Amplatzer봉도술。결과 1례환자인ASD최대신전경대우34 mm，무상응적봉도산이방기봉도술，령1례환자인ASD결손구거우방정거리소우3 mm，치입Amplatzer봉도산미능봉도성공，방기수술치료，여5례성공진행료Amplatzer봉도술。소유병례TEE측량적ASD직경현저소우ASD최대신전경［（17.2±1.9）mm vs （26.8±1.3）mm］，5례성공병례술후즉각、24 h、1개월、3개월행TTE검사，술후무잔여분류，술중、술후무병발증。결론초성심동도재Ⅱ공형방간격결손개입치료중점유겁위중요、불가체대적지위。
Objective　To study the role of echocardiographic guidance in transcatheter losure of ASD with Amplatzer occluder.Methods　Seven patients with ASD were treated using Amplatzer occluder by transesophageal echocardiography (TEE) under transthoracic echocardiography and X-ray guidance.Results　Five patients were treated successfully. The mean ASD diameter measured by echocardiography was significantly smaller than the mean stretched diameter of the ASD′s ［(17.2±1.9)mm vs (26.8±1.3)mm］. The cases were optimal and no residual shunt was found by TTE immediately,24 hour,1 month and 3 month after the procedure.No complications were observed during the 3 month follow-up.One patient with stretched diameter＞34 mm was given up due to the lack of large size Amplatzers and another patient with gap at <3 mm to the top right atrium was also given up. Conclusions　Transthoracic echocardiography is important and irreplacable in the transcatheter closure of ASD using Amplatzer occluder.