| Objective: To observe transcatheter treatment of the atrial septal defect(ASD) and patent ductus arteriosus(PDA) on cardiac structure change to evaluate effectiveness of transcatheter treatment in the near and mid term.Methods: From February 2014 to February 2015 in the Department of Cardiology of Attached Hospital of Zunyi Medical College and underwent percutaneous catheter interventional treatment of 44 atrial septal defect(ASD) and 33 patent ductus arteriosus(PDA) patients. In group ASD, 19 cases were male, 25 were female, mean age 29.55±12.35 years; In group PDA, 15 cases were male, 18 were female, mean age 19.48 ± 12.64 years old. Into the group of patients before clinical symptoms, physical examination,ultrasonic cardiogram(UCG), chest X, 12 lead electrocardiogram(ECG) of congenital heart disease. Do UCG in operation before and after 3 days, 1 month, 3 months, 6 months and after 1 year, measurement of left atrial end systolic diameter(LAs),left ventricular end systolic(LVSd),left Ventricular End Diastolic Diameter(LVDD), right atrial diameter(RAd)and right ventricular diameter(RVd), mitral valve early velocity(MVAV), mitral valve advanced velocityand(MVEV), left ventricular ejection fraction(LVEF). SPSS17.0 was used for statistical processing, all measurement data were already mean standard deviation( x ±s),the ASD group compared with variance analysis, first with finishes of variance homogeneity examination, homogeneity of variance using LSD method, homogeneity of variance using tamhane,sT2; PDA group using a paired T test, P<0.05 was statistically significant.Results:(1) By ultrasonic cardiogram showed that the preoperative ASD group of RAd had significantly decreased compared with 1 months operation(32.70±3.84 mm vs 31.03±3.12 mm, P<0.05), postoperative 1 month compared to postoperative 1 year still havedecreased(23.83±5.40 mm vs 22.93±4.83 mm, P<0.05); RVD preoperative compared to postoperative 1 month had significantly decreased(22.83±4.12 mm vs 20.90±4.22 mm,P<0.05), postoperative 1 month compared to postoperative 3 month have still decreased(20.90±4.22 mm VS 19.03±4.42 mm, P<0.05), 3 months to 1 year after operation operation have no obvious changes; MVEV preoperative compared to postoperative 3 days have significantly rised(95.21±20.05cm/s vs 104.57±18.60cm/s, P<0.05), 1 month to 1 year after surgery have no significant changes. Preoperative and postoperative of LAs, LVSd,LVDd, MVAV, LVEF have no significant changes.(2) By ultrasonic cardiogram showed that the preoperative PDA group of LAs have decreased compared with 1 months operation(32.7±3.84 mm vs 31.03±3.12 mm, P<0.05), postoperative 1 month compared to postoperative 3 month have decreased(31.03±3.12 mmmm vs 29.12±3.87 mm, P<0.05),postoperative 3 month compared to postoperative 6 month still have decreased(29.12±3.87 mm vs 26.48±4.30 mm, P<0.05), there was no significant change in 6 months and 12 months after operation; LVDd preoperative compared to postoperative 1 month had decreased(42.52±4.44 mm vs 41.52±3.52 mm, P<0.05), postoperative 1 month compared to postoperative 3 month still have decreased(41.52±3.52 mm vs 39.79±3.44 mm, P<0.05),postoperative after 6 month to 1 year have no obvious change; LVSd preoperative compared to postoperative 1 month had decreased(34.12±2.65 mm vs 33.21±2.17 mm, P<0.05), postoperative 1 month compared to postoperative 3 month still have decreased(33.21±2.17 mm vs 32.18±1.98 mm, P<0.05), postoperative after 6 month to 1 year have no obvious change; MVEV preoperative compared to postoperative 3 days had significantly rised(77.52±24.11cm/s vs 86.79±20.10cm/s, P<0.05), postoperative 3 days compared to postoperative 1 month was still significantly increased(86.79±20.10cm/s vs98.12±16.28cm/s, P<0.05), 3 month to 1 year after operation have no obvious change;Preoperative and postoperative of RAd, RVd, MVAV and LVEF have no significant changes.Conclusion:(1) Atrial septal defect patients intervention after transcatheter closure of right atrial and right ventricular structure is improved, left atrial and left ventricle had no obvious change;(2) Patent ductus arteriosus interventional therapy in patients with leftventricular and left atrial structure improved, right atrial and right ventricular no obvious improvement;(3) Transcatheter therapy of ASD and PDA is an effective method to improve the structure of the heart.Objective: To observe the effect of transcatheter treatment of ventricular septal defect after left atrial volume index and cardiac structure changes, evaluation of left atrial volume index for transcatheter treatment of ventricular septal defect cardiac function after recovery.Methods: 20 cases of ventricular septal defect(VSD) during March 2015 to August 2015 in the Department of Cardiology of Attached Hospital of Zunyi Medical Collegel and underwent percutaneous interventional therapypatients, 11 were male, 9 female, mean age19.28±10.64 years ago, Into the group of patients before clinical symptoms, physical examination, ultrasonic cardiogram(UCG), chest X, 12 lead electrocardiogram(ECG) of congenital heart disease. Do UCG in operation before and after 3 days, 1 month, 3months,6 months and body weight measurement(accurate to 0.5kg). UCG measurements:systolic left atrial diameter(LAs), left ventricular end systolic diameter(LVSd), left ventricular diastolic diameter(LVDd), right atrial diameter(RAd), right ventricular diameter(RVd),mitral valve early velocity(MVAV), mitral valve advanced velocityand(MVEV),left ventricular ejection fraction(LVEF); Using single plane Simpson method, get the end diastolic left atrial volume(LAV) in four chamber view through the instrument software, according to the BSA =0.035W±0.1(≤30kg) or BSA=1.05±(W-30) *0.02(W>30kg) to calculate the surface area. The left atrial volume index LAVI(ml/m2)=LAV/BSA. SPSS17.0 was used for statistical processing, all measurement data were already mean standard deviation( x ±s), using the paired T test, P < 0.05 was statistically significant.Results: By ultrasonic cardiogram showed that LAVI preoperative compared to postoperative 3 days have significantly decreased( 46.59 ±4.96ml/m2 vs 43.92±10.06ml/m2,P<0.05), postoperative 3 days compared to postoperative 1 month still decreased(43.92±10.06ml/m2 vs 41.46±9.11ml/m2, P<0.05), there was no obvious changes after 1 months to 6 months; MVEV preoperative compared to postoperative 3 days have significantly rised(90.2±17.51cm/s vs 105.25±18.24cm/s, P<0.05), there was no obvious changes after 3 days to 6 months; MVAV preoperative compared to postoperative 3 days have significantly decreased(70.5±15.33cm/s vs 59.45±12.6cm/s, P < 0.05), there was no obvious changes after 3 days to 6 months; LAs preoperative compared to postoperative 3days have significantly decreased(24.55± 5.11 mm vs 23.00±5.13 mm, P<0.05),postoperative 3 days compared to postoperative 1 month is still arrowing trend(23.00±5.13 mm vs 21.80±5.35 mm, P<0.05), There was no change in 1 months and 6months after operation; LVDd preoperative compared to postoperative 1 month have decreased(40.05±7.93 mm vs 38.10 ±5.90 mm, P<0.05), postoperative 1 month compared to postoperative 3 months still have decreased(38.10±5.90 mm vs 37.15±5.54 mm,P<0.05), there was no change in 3 months and 6 months after operation; LVSd preoperative compared to postoperative 1 month have decreased(25.85±5.23 mm vs24.40±4.27 mm, P<0.05), postoperative 1 month compared to postoperative 3 months still have decreased(24.40±4.27 mm vs 23.20±4.11 mm, P<0.05), there was no change in 3months and 6 months after operation; LVA preoperative compared to postoperative 3 days have decreased(43.15±11.68 m L vs 41.50±10.74 m L, P<0.05), postoperative 3 days compared with the postoperative 1 month still have decreased(41.50±10.74 m L vs37.90±6.80 m L, P<0.05), there was no obvious changes after Postoperative 1 months to 6months; Preoperative and postoperative of RAd, RVd and LVEF have no obvious change.Conclusion:(1) Left atrial volume index is a good indicator for evaluation of ventricular septal defect after catheter in the treatment of heart function recovery;(2) Transcatheter therapy for patients of ventricular septal defect recently, the left atrium and the left ventricular structure improved, right atrial and right ventricular no obvious change. |
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