Objective:To evaluate the effect and safety of ultrasound-guided closure of secundum atrial septal defect(ASD),and to identify relevant quantitative indicators.Methods:A retrospective analysis was conducted on 116 patients with secundum ASD who underwent minimally invasive closure guided by transesophageal echocardio-graphy(TEE)in our hospital from December 2020 to December 2023.We detected the radiation compression(waist diameter after unfolding the occlusion umbrella under X-ray)and ultrasound compression(waist diameter after unfolding the occlusion umbrella under intraoperative TEE),and calculate the radiation compression ratio.The formula is:compression ratio=(occlusion umbrella model-actual measurement value)/occlusion umbrella model × 100.The changes in cardiac structure before and after occlusion were compared,and the correlation be-tween defect size and compression ratio was analyzed.Binary logistic regression analysis was used to evaluate the factors affecting changes in cardiac structure.Postoperative complications were also followed up.Results:After the occlusion surgery,the right heart system significantly shrank and the left heart increased,with statistically significant differences(P＜0.05).The radiation compression ratio and ultrasound compression ratio were(23.47±9.36)％and(36.01±8.40)％,respectively.The compression ratio is negatively correlated with right ventric-ular changes and defect size(P＜0.05),indicating that the larger the defect,the smaller the compression ratio.There is a strong positive correlation between the radiation compression ratio and the ultrasound compression rati-o.Three cases of occluder detachment occurred postoperatively,with radiation compression ratios of 5.00％,8.33％,and 5.26％,and ultrasound compression ratios of 17.50％,13.89％,and 7.89％,respectively.The 5 cases showed residual shunting,which disappeared after 6 months of follow-up;One case of pericardial tamponade occurred without any deaths.Logistic regression analysis showed that defect size was an independent predictor of right ventricular structural remodeling(OR=1.273,95％CI 1.148-1.411).Conclusion:Compression ratio can be used as a quantitative indicator to evaluate the safety of ASD closure surgery.A smaller compression ratio may indicate a risk of occluder detachment.The size of the defect is a predictive indicator of right ventricular structural remodeling.
atrial septal defect,occlusiontransesophageal echocardiographystructural remodelingcom-pression ratio
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