【摘要】 目的 :研究非常规方法选择 Amplatzer房间隔缺损封堵器的可行性。方法 :患者 15 8例 ,年龄 1～ 6 5 (2 7士 19)岁。其中常规组 4 1例 ,非常规组 117例。非常规组按照选择封堵器的最终依据不同 ,分为 3组。A组 :33例 ,根据食道超声心动图 (TEE)测量的 ASD最大径直接选择封堵器 ;B组 :4 6例在经胸超声心动图 (TTE)监测指导下球囊充盈测量 ASD伸展径 (BSD) ,根据 BSD选择封堵器 ;C组 :38例 ,根据 TTE测量的 ASD最大径直接选择封堵器。结果 :各组患者 ASD的边缘、大小和选择封堵器的大小之间均无显著性差异 (P>0 .0 5 )。各组技术成功率均为10 0 %。非常规各组完全闭合率与常规组无显著性差异 (P>0 .0 5 ) ,但手术操作时和 (或 )透视时间均明显短于常规组 (P<0 .0 1)。结论 :非常规法选择 Amplatzer封堵器对大部分 ASD介入治疗是安全可行的。对于房缺周缘较长、较硬者 ,及边缘为硬缘和极软缘组成而剔除极软缘者 ,TEE或 TTE可直接指导 Amplatzer封堵器型号的选择。对于房缺缘较软者 ,应结合球囊测量房缺伸展径选择封堵器更多还原

【Abstract】 AIM: To investigate the feasibility of the selection of Amplatzer septal occluder(ASO) device by means of unconventional methods. METHODS: There were 158 patients. The mean age was 26.8±18.6 years (ranging from 1 to 65 years). The patients were divided into 2 groups, the conventional group ( n =41) and the unconventional group ( n =117) according to the way of ASO selection. The 117 patients in the unconventional group were divided into 3 groups. In group A( n =33), ASO device was selected based on the transeophageal echocardiograph (TEE) . In group B(n=46) as device was selected according to the balloon stretched diameter(BSD) measured by transthoracic echocardiography(TTE); and in group C ( n =38),the ASO device was chosen according to the TTE measured diameters. RESULTS: There was no significant difference between the four groups in the largest ASD diameter measured by TTE or TEE,the size of ASD edge and the size of implanted ASO devices ( P >0.05). There were all successful implantations in the four groups. The rates of complete closure of ASD were not significantly different between the four groups soon after the implantation, 1 day after the implantation, and in a short time follow up duration( P >0.05). Both procedural time and fluoroscopy time in unconventional group were significantly shorter than those in the conventional group ( P <0.01). CONCLUSION:Transcatheter closure of secundum ASD occlusion with ASO by unconventional methods was safe and efficient in some ASD patients. TEE or TTE can be used for guidance of ASO selection of ASD without the measurement of BSD of ASD in the following conditions:① ASD with solid edge;② ASD with very soft and floppy edge attached to solid basement,with only the solid basement measured with TEE. However, BSD should be measured in ASD with soft and floppy edge.更多还原