Study On The Clinical Value Of TTE In Diagnosis And Treatment Of Aneurysms Of Membranous VSD

Objective:The study aimed to discuss the clinical value of transthoracic echocardiography to aneurysms of membranous ventricular septal defect in diagnosis,differentiation and treatment.Methods:82 aneurysms of membranous ventricular septal defect patients from the first affiliated hospital of Kunming Medical University who were diagnosed by transthoracic echocardiography Dec.2017 to Mar.2020 were classified by type of aneurysms of membranous.Among them,68 cases were true aneurysms of membranous and 14 cases were pseudo aneurysms of membranous.Comparison of left ventricular angiography and transthoracic echocardiography in 14 patients with pseudo aneurysms of membranous ventricular septal defect to evaluate the accuracy of transthoracic echocardiography in differential diagnosis;The 68 patients with true aneurysms of membranous ventricular septal defect were divided into observation group and control group randomly.The observation group of transcatheter closure guided by transthoracic echocardiography and the observation group used the method of conventional transcatheter closure.The incidence(including heart valve injury,infective endocarditis,occluder displacement or falling off,arrhythmia or not)and the improvement of postoperative cardiac function were compared,and were analyzed using method of statistics.Results:1.In the comparison of the results of transthoracic echocardiography and Left ventricular angiography in patients with pseudo aneurysms of membranous ventricular septal defect,there were no significant differences in the edge morphology,wall thickness,adhesion and other indicators between the two examination modes,and there was no significant difference in the difference of the diameter of the main ventricular septal defect measured by the two methods(P>0.05).It is suggested that transthoracic echocardiography has high accuracy in detecting pseudo aneurysms of membranous ventricular septal defect.2.In the study of modified transcatheter closure of ventricular septal defect for patients with true aneurysms of membranous ventricular septal defect.There was no significant difference in the basic information of the two groups(P>0.05).3.There was no significant difference between the two groups in the success rate of operation(?2=0.183,P=0.669)and the immediate complete rate of transcatheter closuring(?2=0.227,P=0.633),but the two indexes in the observation group were higher than those in the control group4.There was a significant difference between the two groups in the operation time and the amount of radiation.There was no significant difference between the two groups in the length of hospital stay(P>0.05).5.The incidence of postoperative arrhythmia and postoperative valve regurgitation in the observation group was lower than that in the control group,but there was no significant difference between the two groups(P>0.05).6.There was no significant difference between the two groups in terms of left ventricular structure,left ventricular function and pulmonary artery pressure(P>0.05)3 days after operation(P>0.05),and the change trend of the mean value of the two groups was not significant;the difference between the two groups in terms of pulmonary artery pressure was statistically significant and significant(P<0.01),but the change trend of the mean value of the two groups was not significant;the difference between the two groups in terms of LVEF data was not significant The difference was statistically significant(P=0.021 in the control group and P=0.020 in the observation group),but there was no significant difference between the two groups in the trend of data mean change.Conclusions:1.Transthoracic echocardiography plays a key role in the differential diagnosis of true aneurysm of membranous ventricular septal defect and pseudo aneurysm of membranous ventricular septal defect with high accuracy.2.Transthoracic echocardiography-guided transcatheter closure of true aneurysm of membranous ventricular septal defect can effectively reduce the operation time and radiation dose,have possibility to improve the success rate of the operation,reduce the occurrence of postoperative arrhythmias and residual shunts.3.Transthoracic echocardiography is widely and effectively used before,during and after interventional treatment of aneurysm of membranous ventricular septal defect,and has a space for re-development,which is of great value in the formulation of follow-up treatment strategies for true and pseudo aneurysm of membranous ventricular septal defect.