| 摘要: |
| 【】 目的：探讨经食管超声心动图(Transesophageal echocardiography,TEE)在经皮左心耳封堵术后随访中产生残余分流的原因,指导术中释放封堵器。 方法：2014年1月-2015年12月武汉亚洲心脏病医院54例心房颤动患者均使用Watchman封堵器成功实施左心耳封堵术。术前TEE0°、45°、90°、135°分别测量左心耳的最大开口径与最大深度；术后即刻及45天随访观察封堵器形态、位置,分别测量封堵器腰部直径,计算压缩比。 结果：1)51.8%(28/54)患者术中及术后45d均未出现残余分流；29.6%(16/54)患者术中出现残余分流(＜5mm),术后45d复查残余分流仍存在(<5mm)；18.5%(10/54)的患者术中未出现残余分流,术后45d复查出现残余分流(<5mm)；2)TEE135°扫查较其它角度检测出残余分流更敏感；3)所有随访患者均未出现脑血管或其他血管栓塞事件,术中出现少量心包腔积液3例,术后7d复查均未见心包腔积液,2例术后45d复查封堵器表面出现血栓。 结论：经食管超声心动图在左心耳封堵术后随访中有重要的应用价值。 |
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| DOI： |
| 投稿时间：2018-06-13修订日期：2018-07-30 |
| 基金项目: |
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| Residual shunt analysis of LAA closure by TEE follow-up |
| wuchunxia,maxiaojing |
| () |
| Abstract: |
| Objective: Objective to investigate the causes of residual shunt after transcatheter closure of percutaneous left atrial appendage by transesophageal echocardiography (TEE) and to guide the release of occluder. Method：In January 2014 -2015 December, 54 patients with atrial fibrillation in Wuhan Asian heart hospital were successfully treated with left atrial appendage with Watchman occluder. The maximum opening and maximum depth of left atrial appendage were measured at TEE0, 45, 90 and 135 degrees before operation. The shape and position of occluder were observed immediately and 45 days after the operation. The diameter of the occluder was measured and the compression ratio was calculated. Result：1) there was no residual shunt during and after operation in 51.8% (28/54) patients; residual shunt was found in 29.6% (16/54) patients (< 5mm), and residual shunt still existed after 45d review (<5mm); 18.5% (10/54) had no residual shunt during operation, and residual shunt (<5mm) was found after operation 45d;2) TEE135 degree scan is more sensitive than other angles to detect residual shunt; 3) all patients had no cerebrovascular or other vascular embolism, 3 cases of pericardial effusion appeared in the operation, no pericardial effusion was found in 7d reexamination after operation, and thrombus appeared on the surface of occluder after 45d reexamination in 2 cases. Conclusion: Transesophageal echocardiography plays an important role in the follow-up of left atrial appendage occlusion. |
| Key words: Atrial fibrillation left atrial appendage closure transesophageal echocardiography residual shunt. |
