The Exploration Of The Function Of CDE And TDI In The Prevention On Aged Atrial Septal Defects.

Objective: To evaluate the changes before and after aged atrial septal defect (ASD) occlusion by using color Doppler echocardiography(CDE)and Tissue Doppler Imaging (TDI).Methods: Prevention of the 33 cases of aged ASD from May 2003 to Dec 2007, within which 23 cases for females and 10 for males, varied from 60 to 72 with averaged age 65.5. CDE was applied to select patients a week before the prevention. Firstly, was applied on SC-4CV, PS-AR-SAV and SC-2CV to observe the size of ASD and damaged edge. CDFI was applied on the above-mentioned sections to observe the signals of shunt and various valve streams passing through IAS. Measurement was undertaken on the left-right diameters and long diameters of RA and RV during DS and SS, the left-right diameters and long diameters of LA during DS, the anterior-posterior of PS-LVLAV of LV, the anterior-posterior of LV during DD and SS. Calculation of LVESV, LVEDV, LVFS, LVEF, and LVSV with formula Cube. Sampling line was parked on TV and measured mitral valves of the blood stream at E Peak and A Peak. Measurement was undertaken on pulmonary artery meatus at PS-AR-SAV to get Vmean ,Vmax and VTI. TDI process was carried out 2DE SC-4CV to measure the S', E', A' of MVA, Combination of monstrosities. CDE was applied to repeat the above-mentioned check after a week, 6 months and a year. The measured data was used to statistical match inspection to find the differences of the indexes before and after prevention.Results: 1.Involved change on one week, six month and one year after ASD occlusion: (1) The change of chamber load: All diameters of right heart and middle part of pulmonary artery were markedly decreased on one week after occlusion (P<0.05); while the diameter of left heart, especially antieror-postieror diameter and left-right diameter of left ventricle were significantly augmented on one week after occlusion (P<0.05). The parameters above mentioned were further gradually recovered on 6 months and one year. (2) Hemodynamic change: Left to right shunt in atrial level disappeared after occlusion. Compared with the data before occlusion, E peak and A peak velocities of tricuspid valve as well as maximal, were significantly reduced (P<0.05) on one week, six months and one year after occlusion. (3) The change of cardiac function measured by TDI: On one week, six months and one after ASD occlusion significant decrease of TDI velocity were noted on following waves and positions (P<0.05): S', E' and A' peak velocities on base and middle parts of right ventricular lateral wall: S', E' and A' velocities on base part of ventricular septum: S' velocities on base and middle parts of left ventricular lateral wall. However, S' and E' velocities on middle part of ventricular septum were significantly reduced only on one week (P<0.05).Conclusion: CDE and TDI are simple and valuable methods for observation on the effect of aged ASD occlusion, which may supply useful information for clinical doctors. Especially, they are special on observing hemodynamic, cardiac chamber and function changes before and after occlusion. This study shows that abnormal hemodynamics, preload increasement of cardiac chamber and it's morphological abnormality, as well as systolic and diastolic function of left and right ventricle observed by the use of CDE and TDI recovered after ASD occlusion.