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目的探讨心腔内超声(ICE)在经导管卵圆孔未闭(PFO)封堵术中的初步应用经验及其与X线的比较。方法应用ICE监测与引导86例PFO的封堵过程,在ICE上测量基础状态PFO通道的直径和长度,分别用ICE和X线透视测量PFO球囊伸展径(BSD)。ICE观察封堵器释放后的位置,并通过彩色血流显像和声学造影判断有无残余分流。结果ICE清晰地显示PFO解剖形态及周围结构,在ICE上测量基础状态PFO通道长度和直径分别为3.6~22mm(11±4mm),0~9mm(4±2mm)。ICE上测量的PFO球囊伸展径为5~16mm(9.2±2.6mm),经X线透视测量的PFO球囊伸展径为5~17mm(9.7±2.8mm),二者相关非常显著(r=0.90,P<0.0001),86例中有85例封堵成功,1例失败。结论ICE不仅能提供PFO的解剖和血流动力学信息,而且能准确提供PFO各种测量值。
Objective To investigate the preliminary application experience of intracardiac echocardiography (ICE) in transcatheter closure of patent foramen ovale (PFO) and its comparison with X-ray. Methods ICE was used to monitor and guide the occlusion of PFO in 86 cases. The diameter and length of PFO channel were measured on ICE. The PFO balloon diameter (BSD) was measured by ICE and X-ray respectively. ICE observed occluder release position, and through color flow imaging and acoustic contrast to determine whether the residual shunt. Results ICE clearly showed the anatomy and surrounding structures of PFO. The length and diameter of the PFO channel measured at ICE were 3.6-22mm (11 ± 4mm) and 0-9mm (4 ± 2mm), respectively. The diameter of PFO balloon measured on ICE was 5 ~ 16mm (9.2 ± 2.6mm), and the diameter of PFO balloon measured by X-ray was 5 ~ 17mm (9.7 ± 2.8mm). The correlation between them was very significant (r = 0.90, P <0.0001), 85 cases of 86 cases were successfully blocked and 1 case failed. Conclusion ICE not only provides anatomic and hemodynamic information on PFO, but also accurately provides various measurements of PFO.