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Objective To explore a more minimally invasive and economical treatment for atrial septal defect (ASD) through comparing the efficacy and safety in percutaneous transcatheter closure of atrial septal defect procedure,guided by transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods From March 2014 to September 2017,197 patients with ASD who were feasible to treated with percutaneous transcatheter closure procedure evaluated by preoperative ~ were recruited.TTE showed ASD belonged to secundum(central type) with a maximal diameter range from 2 mm to 35mm,including 82 cases of the ASD without aortic rim.There were 106 patients(47males and 59 females including 37 ASD without aortic rim) with a mean age of 14.2 years(6 months-59 years) old and a mean body weight of 29.5(8.5-64.0)kg were performed percutaneous transcatheter closure of ASD guided by TEE under general anesthesia and endotracheal intubation,and 91 patients(41males and 50 females with 45 ASD without aortic rim inside) with a mean age of 13.8 years(9 months-65 years) old and a mean body weight of 30.4 (9.5-61.0)kg were treated with the percutaneous transcatheter procedure guided by TTE when patients in waking state of local anesthesia(general anesthesia were adopted in patients under 12 years old without intubation).The size of the occluder was selected on the basis of the maximal diameter plus 2-6mm.All 197 cases intraoperation and postoperation data were collected,including complications 、operation time 、operation room stay time and total cost.Results 1 patients in 106 cases of the the TEE group were transferred to small incision on the chest performing transthoracic transcatheter closure of ASD because the difficult stuck of the occluder.3 patients in TEE group transferred to repair under cardiopulmonary bypass(CPB) via small incision on the chest because the difficult stuck of the occluder even in using transthoracic transcatheter closure way.86 patiens in TTE group successfully treated with percutaneous transcatheter closure,and there were 5 failed cases including 2 patients who transferred to TEE guided because of the poor imaging of TTE,another 2 cases treated with transthoracic transcatheter closure of ASD because the difficult stuck of the occluder,and 1 patient performed ASD repair procedure under CPB via small incision on the chest because of the huge ASD without aortic rim and difficult stuck of the occluder.All the 197 patients were cured and discharge from hospital,and there were no complications.There was no significant difference in age,weight,and maximum diameter of ASD between TEE group and TTE group (P ＞ 0.05).Follow-ups were conducted by TTE at month 3 post-operation,and all 197 cases performed no residual shunt of ASD,there were no difference between 2 group.The stay time in the operation room was(68.2 ± 17.3) min in group TEE and (34.7 ± 16.8) min in group TTE,there was obviously shortened the stay time in operation room(P ＜0.01).The total cost of the TTE group was(24.2 ± 2.1) thousand yuan,and the group TEE was(29.3 ± 1.4) thousand yuan,and the cost was significantly reduced in TTE group (P ＜ 0.01).Conclusion The treatment of percutaneous transcatheter closure of ASD guided by TTE is effective and safe,and the feature of more non-invasive and socioeconomic benefits show a broad application prospect.
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Objective:To explore the diagnostic value of color Doppler echocardiography for cardiac tumors .Meth-ods:Clinical data of 87 patients with cardiac tumors were retrospectively analyzed ,including their diseased loca-tion ,clinical manif′estations and echocardiography feature .Results:All cardiac tumors obtain pathologic confirma-tion .There were 73 patients (83.9% ) with benign cardiac tumors ,including 66 patients (90.4% ) with myxoma and seven patients with other types ;there were 14 patients (16.1% ) with malignant cardiac tumors .Echocardiography indicated that myxoma was often located in left atrium (n=58) ,most cases possessed pedicell,its activity was large ;Other type benign cardiac tumors feature :The 6 case (86% ) were generated inside cardiac muscle without pedicell, its echo was more strong ;malignant tumors:its attachment surface was wide without pedicell,and it may show with globular or cauliflower ,and accompanied hydropericardium mostly .Conclusion:Echocardiography can dynamically observe the form ,size ,echo and hemodynamic changes of tumors ,its diagnostic accuracy is high .Myxoma is most frequent cardiac tumor .
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ObjectiveTo evaluate the role of detecting early change of left ventricular regional myocardial function in the rabbit with type Ⅰ diabetes using omni-directional M-mode echocardiography (OME).MethodsEighty New Zealand rabbits were selected in this study..40 health rabbits were included in the control group,the other 40 with type Ⅰ diabetes were included in the experiment group.The OME was used to measure the peak time of myocardial motion during systole (Ts) and diastole (Td),myocardial velocity gradient during systole (MVGs) and diastole (MVGd) on the left ventricular short axis.These parameters were measured during the first,second,fourth,sixth and eighth week.ResultsOME was able to detect significant changes of Td during the second week,Ts and MVGd during the fourth week,and MVGs during sixth week after modeling ( P ＜0.05 ).ConclusionsOME is an important method to detect early changes of regional myocardial function in the patients with diabetes.
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Objective To investigate the consistency of omnidirectional M-mode echocardiography and two-dimensional strain in assessment of left ventricular (LV) radial systolic asynchrony. Methods Thirty patients with heart failure (HF) and 28 healthy volunteers underwent omnidirectional M-mode echocardiography and two-dimensional strain at the same time. The time to peak radial systolic movement (T_m) of LV in 12 segments were measured with omnidirectional M-mode echocardiography and its standard deviation (T_m-12-sd), and the maximum difference (T_m-12-dif) were calculated. The time to peak radial systolic strain (T_(SR)) of LV in 12 segments were measured with two-dimensional strain and its standard deviation (T_(SR)-12-sd), and the maximum difference (T_(SR)-12-dif) were calculated. The T_m-12-sd, T_m-12-dif, T_(SR)-12-sd and T_(SR)-12-dif were used as systolic asynchrony indicators. The value (-x)±2s in the control group was defined as the normal upper limit which represents 97.7% of the control group distribution. Any values above this limit in HF patients were classified as LV asynchrony. The results of two methods were analyzed with Kappa test. Results Compared with the controls, T_m-12-sd, T_m-12-dif, T_(SR)-12-sd and T_(SR)-12-dif were significantly higher in the HF group (P<0.001); there was consistency between T_m-12-sd and T_(SR)-12-sd, T_m-12-dif and T_(SR)-12-dif in detecting LV systolic asynchrony in HF group (Kappa=0.661, 0.733). Conclusion T_m-12-sd and T_m-12-dif of omnidirectional M-mode echocardiography have consistency with T_(SR)-12-sd and T_(SR)-12-dif of two-dimensional strain. These two technologies both have ability to evaluate LV radial systolic synchronicity.
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Objective To assess regional myocardial function by left ventricular radial myocardial motion velocity gradient(MVG) measured by omni-directional M-mode echocardiography(OME). Methods There were 32 patients with hypertrophic cardiomyopathy(HCM), 20 patients with hypertension of left ventricular hypertrophy(HLVH),and 36 healthy volunteers in the study, LEJ-2 mode OME was used to measure and calculate MVG of 16 segment on left ventricular short axes. Results In the control group,MVG on left ventricular short axes were found to be decreased progressively from base plane to apical plane. Compared with the control group,the left ventricular MVG were reduced in HCM group and HLVH group( P <0. 05). Conclusions The left ventricular MVG can correspond directly to regional thickened myocardial motion,and can be used to evaluate left ventricular myocardial function in patients with thickened myocardium.
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Objective To assess left ventricular radial systolic synchronicity with omnidirectional M-mode echocardiography (OME). Methods OME examination was performed in 21 patients with dilated cardiomyopathy (DCM) and 27 healthy controls. The time to peak radial systolic movement were measured and adjusted by R-R interval. The standard deviation (Tc-SD)and the maximal temporal difference (Tc-dif) of the time to peak radial systolic movement of left ventricular short-axis segments at basal and mid-levels, the septal-to-posterior wall motion delay (SPWMD), septal-to-anterior wall motion delay (SAWMD), septal-to-laterior wall motion delay (SLWMD), septal-to-inferior wall motion delay (SIWMD) and anterior-to-inferior wall motion delay (AIWMD) were used as indicators of systolic dyssynchrony.Results Compared with the controls, Tc-dif, Tc-SD, SLWMD, SPWMD and SIWMD in basal level were significantly higher in the DCM group (P<0.05), while Tc-dif, Tc-SD, SAWMD, SPWMD, SIWMD and AIWMD in mid-level were significantly higher in the DCM group (P<0.05).Conclusion Omnidirectional M-mode echocardiography is useful to evaluate the radial systolic synchrony of the left ventricular in patients with dilated cardiomyopathy.