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目的 :经食管超声心动图 (TEE)引导置入Amplatzer封堵器治疗继发孔型房间隔缺损 (ASD)。 方法 :4例ASD患者 ,均为女性 ,年龄 8～ 39( 2 7.75± 13.96 )岁 ,体重 18～ 6 7( 4 2 .0 1± 13.2 0 )kg。在超声和X线透视指导下用Amplatzer双盘封堵ASD。术后重复TEE/经胸超声心动图 (TTE)、ECG及X线平片检查以评价疗效。结果 :4例患者封堵器置入均获成功。术中及术后未发生任何并发症。经TEE测定的ASD直径范围 13～ 2 8mm ,选择封堵器直径为 18～ 32 ( 2 5 .0± 5 .77)mm。术后 2 4h超声心动图显示 4例ASD完全闭合 ,无残余分流。3例完成术后 1个月、1例完成术后 18个月随访均无再通或封堵器移位。结论 :应用Amplatzer封堵器闭合ASD ,TEE在术前选择病例、术中引导封堵器置入及术后疗效判定等方面具有极其重要的作用
OBJECTIVE: Trans-esophageal echocardiography (TEE) is used to guide Amplatzer occluder in the treatment of secondary atrial septal defect (ASD). Methods: All four ASD patients were female, aged 8-39 (2. 7.75 ± 13.96) years and weighing 18-67 (42.01 ± 13.20) kg. ASD was blocked with Amplatzer double disc under ultrasound and fluoroscopy. Postoperative TEE / transthoracic echocardiography (TTE), ECG and X-ray examination to evaluate the efficacy. Results: Four cases of occluder implantation were successful. No intraoperative and postoperative complications. The ASD diameter measured by TEE ranged from 13 to 28 mm, and the occluder diameter was selected to be 18 to 32 (25 ± 0.577) mm. At 24 hours after echocardiography, 4 ASDs were completely closed with no residual shunt. Three patients completed one month after operation, and none of the patients completed follow-up 18 months after operation. Conclusion: Amplatzer occluder closure of ASD, TEE in the preoperative selection of cases, the introduction of intraoperative occluder guide and determination of postoperative efficacy plays an extremely important role