| 王炯,李治安,张纯.房间隔缺损封堵术后右心血流动力学改变[J].中国医学影像技术,2005,21(2):209~213 |
| 房间隔缺损封堵术后右心血流动力学改变 |
| Hemodynamic change of right heart after transcatheter closure of atrial septal defects |
| 投稿时间：2004-10-06 修订日期：2004-12-10 |
| DOI： |
| 中文关键词: 房间隔缺损 超声心动描记术 多普勒组织成像 经皮心导管封堵术 |
| 英文关键词:Atrial septal defect Echocardiography Doppler tissue imaging Percutaneous transcatheter closure |
| 基金项目: |
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| 摘要点击次数: 1861 |
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| 中文摘要: |
| 目的 观察房间隔缺损封闭后右心血流动力学的变化。方法 25例成年继发孔房间隔缺损患者,术前、术后48~72 h及3个月后经胸超声心动图检查,测量缺损、三尖瓣及肺动脉瓣瓣口血流多普勒及三尖瓣前叶瓣环运动的组织多普勒频谱。结果 术前测量缺损平均直径约(2.2±0.6) cm,均成功植入封堵器。术后早期右心收缩期运动速度减低、时间缩短,血流峰值速度及压差降低、射血时间缩短;右房、室间压差降低。3个月后以上参数较术后早期无显著差异,但右室舒张时间延长。结论 右心前负荷的降低短期内使右心-肺循环高动力状态逆转,在新的前负荷水平达到新平衡。 |
| 英文摘要: |
| Objective To observe the impact of change-declined of the right ventricular preload on hemodynamic and movement of the right heart after transcatheter closure of atrial septal defects using Amplatzer occluder. Methods Twenty-five subjects (mean age 31.47±12.73 years, 8 men and 17 women) with secondum atrial septal defects underwent transthoracic echocardiography pre-operation, 48-72 h post-operation and follow-up performed more than 3 months after operation. The diameter of atrial septal defect (ASD), the pulsed-wave Doppler spectrums of the blood flow at the main pulmonary and inlet of the right ventricle, as well as tissue Doppler pulsed-wave signal of the tricuspid annulus at anterior leaflets of tricuspid valves in the para-sternal four-chamber view were acquired. At each position, systolic, early and late diastolic velocities, pressure gradient and intervals were measured. Results All of the patients had been implanted one occluder under the guidance of the echocardiography successfully. Trivial residual shunts were observed at two patients 48-72 h post-operation and disappeared after 3 months. After the operation, the preload of RV was declined immediately and the systolic movement speed and time interval of the right heart were decreased and shortened significantly, the ejection time was shortened and the blood peak velocity and pressure gradient in the systolic period were reduced, the early and late diastolic inflow blood velocities and pressure gradients also decreased significantly, the late diastolic movement velocities decreased. During the more than 3 months short-time follow-up, however, the hemodynamic parameters above had no significant difference compared with 48-72 h', the whole diastolic time was prolonged. Conclusion Preload of right heart changed quickly after the operation, and had a significant effect on the hemodynamic and the myocardial movements of right heart, which improved the RV functions segmentally. |
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