Feasibility of transesophageal echocardiography guided transthoracic incision closure of aortic sinus aneurysm rupture / 中国医学影像技术

ABSTRACT

Objective To explore the feasibility of transesophageal echocardiography (TEE) guided transthoracic incision closure of aortic sinus aneurysm rupture (RASA).Methods Data of 30 patients with RASA underwent TEE guided transthoracic incision closure of RASA were retrospectively analyzed.The distance between the coronary artery ostium and crevasse was measured in right coronary sinus aneurysm rupture patients.During the operation,the guide wire and sheath pipe were guided accurately into rupture mouth of aortic sinus aneurysm with TEE.After the operation,the position of closure and the function of aortic valves were checked carefully,while in right coronary sinus aneurysm rupture patients,coronary ostium should not be occluded by the occluder.Results Totally 20 of 30 patients accepted interventional treatment successfully.Right coronary sinus aneurysm rupture was found in 10 patients,including 7 with rupture developing into right ventricle and 3 with rupture into right atrium.Posterior coronary sinus tumor rupture was found in 10 patients,including 8 with rupture developing into right atrium and 3 with rupture into right ventricle.Patients who received intervention treatment successfully had stable vital signs,and no obvious changes of heart cavity structure and cardiac function was found.Postoperative multiple reexaminations showed all patients had normal closure position,aortic valve opening and closing movement was normal.No stenosis,reflux signal nor residual shunt were found.Conclusion RASA can be diagnosed accurately with TEE,and the occluder can be placed guided by TEE.TEE guided transthoracic incision closure of RASA is a feasible method.