【摘要】 目的:观察经食管超声心动图(TEE)在引导左心耳(LAA)封堵术中的应用。方法:对符合入选标准的8例非瓣膜性心房颤动患者经术前TEE观察LAA口形态、分叶情况,判断LAA有无血栓,测量LAA口大小及LAA口最大长径,评估LAA各参数与置入封堵器尺寸的关系;术中超声引导房间隔穿刺和封堵器的释放,并评估封堵器位置是否合适;术后观察及随访LAA封堵术效果及内皮化程度。结果:8例患者术前和术后45 d随访时,左心房内径、右心房内径、LVEDd及LVEF比较,差异无统计学意义(P>0.05);8例患者LAA封堵术全部成功,手术成功率100%;无严重并发症发生,1例患者术后1周复查左房心耳处见少量血栓形成。结论:经TEE引导下行LAA封堵术成功率较高,可降低并发症发生率,在术后疗效评估中起着重要指导作用。更多还原

【Abstract】 Objective:To determine the value of transesophageal echocardiography(TEE) in guiding left atrial appendage(LAA) occlusion. Methods:Eight patients with non-valvular atrial fibrillation who met the inclusion criteria were enrolled in the study. Before the procedure, the patients underwent TEE to investigate the morphology and lobulation, presence of thrombus, the size and maximum length-diameter of LAA. The relationship between LAA parameters and size of inserted occluder was evaluated. Intraoperative ultrasound was performed to guide atrial septal puncture, occluder release and to evaluate the proper placement of the occluder. After the procedure, the patients were observed and followed up for the outcome of LAA occlusion and endothelialization. Results:There were no statistically significant differences in left atrial diameter, right atrial diameter, LVEDd or LVEF among the 8 patients before the surgery and during follow up at 45 d after surgery(P>0.05).The LAA occlusion was 100% successful for all the 8 patients. There were no serious complications. Minimal thrombosis in LAA was noted in one case during follow up at 1 week after the surgery.Conclusion:TEE guided LAA occlusion surgery may result in high success rate and reduced complications, and therefore appears valuable in evaluation of postoperative treatment outcome.更多还原