心腔内声学造影技术在单纯经胸超声心动图引导下经皮行心房水平缺损封堵术中应用的安全性及临床价值
Safety and Application Value of Intracardiac Contrast Echocardiography in Percutaneous Closure of the Defect Be-tween the Atria Guided by Transthoracic Echocardiography
唐仕海 1刘浪 1赵飞 1郑波 1何佳林 1邵剑鹏1
作者信息
- 1. 乐山市人民医院心脏大血管外科,四川 乐山 614000
- 折叠
摘要
目的 探讨心腔内声学造影(ICCE)在单纯经胸超声心动图(TTE)引导下行心房水平缺损介入封堵术中应用的安全性及临床价值.方法 回顾性分析我院2021 年4 月至2022 年7 月单纯TTE引导下经皮行心房水平缺损介入封堵术且术中予以含血激活生理盐水行ICCE的病例资料,共148 例,诊断房间隔缺损9 例,诊断卵圆孔未闭139 例,平均年龄(47.53±14.52)岁.统计患者术前基线资料,比较ICCE前后基础生命体征变化等.统计经ICCE校正后单纯TTE判断端孔导管通过卵圆孔进入左心系统正确率.结果 直接予以含血激活生理盐水行ICCE前后基础生命体征结果比较,差异无统计学意义(P>0.05);单纯TTE判断端孔导管通过卵圆孔未闭的正确率,经ICCE校正为 73.77%,单纯TTE判断与ICCE辅助下判断结果比较,差异有统计学意义(P<0.05).结论 ICCE以含血激活生理盐水作为造影剂是安全、可行的,辅助判断端孔导管的位置,可以极大降低单纯TTE引导下心脏介入封堵手术的难度,尤其是卵圆孔未闭封堵,并促进此术式的推广.
Abstract
Objective The purpose of this study was to evaluate the safety and application value of intracardiac contrast echocardiography(ICCE),which was being used inpercutaneous closure of the defect between the atria guided by transthoracic echocardiography(TTE)alone.Methods A retrospective analysis was performed on patients who underwent percutaneous closure of the defect between the atria under the guidance of TTE,in which agitate air-blood-saline mixture was used to perform ICCE dur-ing the procedure from April 2021 to July 2022 in our hospital,including 9 cases of atrial septal defect and 139 cases of patent fo-ramen ovale with an average age of(47.53±14.52)years.Preoperative baseline data of patients was collected.The changes of vital signs of pre-ICCE and post-ICCE were compared.The accuracy judged by TTE alone,whether the terminal of catheter passed the PFO or not,was estimated by ICCE.Results The differences of vital signs the pre and post-ICCE with agitate air-blood-saline directly injected in intracardiac were not statistically significant(P>0.05).The accuracy judged by TTE alone,whether the ter-minal of catheter passed the PFO or not,was 73.77%,which was statistically significant compared with the result judged by ICCE(P<0.05).Conclusion The procedure of intracardiac contrast echocardiography using the agitated air-blood-saline as contrast agent is safe and feasible.It can be used to judge where the terminal of the catheter is.It can reduce the difficulty of cardiac inter-ventional occlusion guided by TTE alone,especially for PFO-occlusion,and also promote the implementation of this surgery.
关键词
含血激活生理盐水/心腔内声学造影/经胸超声心动图/卵圆孔未闭/房间隔缺损Key words
agitated air-blood-saline/intracardiac contrast echocardiography/transthoracic echocardiography/patent fo-ramen ovale/atrial septal defect引用本文复制引用
基金项目
四川省医学青年创新科研课题(Q20065)
乐山市重点研究课题(20SZD036)
出版年
2024
国家科技期刊平台
NSTL
万方数据