经食道超声心图评价成人先天性房间隔缺损

目的：探讨经食道超声心动图评价成人先天性心脏病的价值。方法：我们用经食道超声心动图（TEE）诊断成人先天性心脏病173例，156例经心导管和／或手术证实。结果：在131例经手术和／或心导管证实的房间隔缺损（ASD）的病例，经胸超声心动图（TTE）显示ADS109例，TEE显示ASD128例，TTE诊断房间隔缺损的敏感性为83％，TEE诊断房间隔缺损的敏感性为98％，值得注意的是，10例静脉窦型ASD，TTE仅能显示3例，而TEE能观察到所有的10例，且所有的TEE检查的病例，能清晰地观察到与静脉窦型ASD相关的部分肺静脉异位引流，3例冠状静脉窦部位的小ASD，TTE显示2例，但TEE未能显示，结论：TEE探查ADS明显优于TTE，尤其是静脉窦型ASD，但靠近冠状静脉窦部位的小ASD，TEE并不比TTE检查优越，同时TEE对其他先天性心脏病异常结构的观察也提供大量的附加信息。

Assessment of congenital heart diseases with transesophageal echocardiography in adult populations

Abstract:Objective To study the merits oftransesophageal echocardiography (TEE) evaluating con-genital heart diseases in adult populations. Methods173 adult patients with congenital heart diseases werediagnosed with TEE and 156 patients were confirmed bycardiac and/or surgery. Results 131 patients were diag-nosed as atrial septal defects (ASD) by cardiac caiheteri-zation and/or surgery, 109 patients (83%) were detectedASD by transthoracic echocardiography (TTE) and 128patients (98%) were detected ASD by TEE. It is notablethat of 10 patients with sinus venosus ASD, TTE only de-tected 3 patients, whereas TEE detected all 10 patients.In all cases, TEE could visualize partial anomalous pul-monary venous return associated with sinus venosus ASD.TTE could show 2 patients in 3 patients with small coro-nary sinus ASD, but TEE could not show any patient.Conclusion TEE is superior to TTE for the detection ofASD,especially in sinus venosus ASD. TEE is not supe-rior to TTE for the detection of small coronary sinus ASD.TEE could provide substantial additional information overTTE when TEE was used to assess other congenitalanomalies.