Echocardiographic Assessment Of Left Ventricular Form And Function Before And After The Transcatheter Closure Of Ventricular Septal Defect

Objective:Through the application of2D echocardiography (2DE) and single-beat real-time3-dimensional echocardiography (sRT-3DE), this thesis aims to assess the changes in the form, volume, contraction and diastolic function of the left ventricles of the Ventricular Septal Defect (VSD) sufferers after they undergo transcatheter closure; meanwhile, it also probes into the recovery of the left ventricular form and function of the VSD patients in a short period following the closure.Methods:33patients (13males and20females) aged between3and36(mean age11.6±9.2) are diagnosed with Ventricular Septal Defect in No.1Affiliated Hospital of Zunyi Medical College between June to November2011.1day prior to the closure,2DE is used to measure all the patients regarding their left atrial diameter (LAD), left ventricular end-diastolic dimension (LVEDD), left ventricular end-diastolic long diameter(LVEDLD), left ventricular end-diastolic middle period of maximum diameter (LVEDMD), E peak and A peak of mitral diastolic blood flow, left ventricular systolic movement speed (s) and early diastolic movement speed (e) and diastolic late movement speed (a) of mitral valve ring that free wall of left ventricular. Then sRT-3DE is used to take a3D image of a four-chamber view of cardiac apex within a single cardiac cycle, then get left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular stroke volume (LVSV) and left ventricular ejection fraction (LVEF) by aid of the LVA automatic analysis software of the instrument. The above data collection procedure is repeated three days, one month, three months, and five months, respectively, after the operation.2DE and sRT-3DE are applied jointly to assess the changes in cardiac form and functions of VSD patients before and after transcatheter closure.Results:1. Assessment by2DE of Postoperative Changes in Form of Left Ventricle Compared with pre-operation, the LVEDD, LVEDLD, LVEDMD gradually lessen3days,1month,3months and5months following the operation, the difference is statistically significant (P<0.05); there exist no statistically significant difference between 5months and3months after the operation(P>0.05); while the difference between5months after the operation and before the operation shows statistical significance P<0.01). The LAD shows no substantial change three days after the operation, the difference bears no statistical significance (P>0.05). The LAD measured1month,3months and5months before the operation gradually shrinks, in comparison with that measured3days before and after the operation, the difference is statistically significant(P<0.05).2. Assessment by2DE and SRT-3DE of Postoperative Changes in Function of Left VentricleThe E peak rate, A peak rate, measured values of S、e、a and the LVEDV, LVESV significantly drop3days,1month,3months and5months after the operation (P<0.05); Though the LVSV, LVEF decline markedly3days,1month,3months and5months after the operation, yet the difference shows no statistical significance (P>0.05).Conclusion:The transcatheter closure of Ventricular Septal Defect can not only effectively remove interventricular abnormal shunt and reduce left ventricular capacity load, but also make left ventricular form and function reverse in time and restore its normal level. Echocardiography, as a safe, effective, non-invasive screening method, is a first choice for follow-up clinic and assessment of functional recovery of the congenital heart disease, sRT-3DE applied to check cardiac function is more convenient, much handier and better correlative.