Hsiung M C, Ku C S, Wei J, Ding Y A, Lin C C, Wang D J, Shieh S M, Lin K C
Division of Cardiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Echocardiography. 1992 Nov;9(6):583-8. doi: 10.1111/j.1540-8175.1992.tb00503.x.
To determine the value of transesophageal echocardiography in the assessment of prosthetic cardiac valves, 11 patients with clinically suspected cardiac prosthetic valve dysfunction were studied by transesophageal two-dimensional imaging, as well as by color Doppler flow mapping. Among these 11 patients, there were 10 with biological tissue valves and 3 with metallic valves (1 Bjork-Shiley, 2 St. Jude). Nine patients had replacement of mitral valves alone. The remaining two had received both mitral and aortic prostheses. The degree of mitral regurgitation was graded by transesophageal color Doppler according to the area of the regurgitant jet visualized. The degree of aortic regurgitation was graded by the jet height/left ventricular outflow height ratio method. All transesophageal studies were performed without complication and all were well tolerated. The pathological morphology of the cardiac prosthesis was clearly visualized by transesophageal two-dimensional imaging and subsequently proven at surgery. Of those tested, one patient was found to have a torn leaflet, one had a dislodged leaflet, one patient had paravalvular leakage, four had cusp vegetations, and five patients had prosthetic degeneration for other reasons. Mitral regurgitation was graded as absent in one patient, mild in two patients, moderate in two patients, and severe in six patients. Aortic regurgitation was graded as severe in both patients with aortic prostheses. We conclude that in patients with clinically suspected cardiac prosthetic dysfunction, transesophageal two-dimensional imaging combined with color Doppler can provide reliable information that corresponds to surgical findings.
为确定经食管超声心动图在评估人工心脏瓣膜方面的价值，对11例临床怀疑人工心脏瓣膜功能障碍的患者进行了经食管二维成像及彩色多普勒血流成像研究。这11例患者中，10例植入生物组织瓣膜，3例植入金属瓣膜（1例Bjork-Shiley瓣膜，2例圣犹达瓣膜）。9例患者仅置换了二尖瓣，其余2例同时接受了二尖瓣和主动脉瓣置换。经食管彩色多普勒根据反流束可视化面积对二尖瓣反流程度进行分级，主动脉瓣反流程度采用反流束高度/左心室流出道高度比值法分级。所有经食管检查均无并发症发生，患者耐受性良好。经食管二维成像清晰显示了心脏人工瓣膜的病理形态，随后手术证实。在接受检查的患者中，1例发现瓣叶撕裂，1例瓣叶移位，1例瓣周漏，4例瓣叶赘生物，5例因其他原因出现人工瓣膜退变。二尖瓣反流程度分级为：1例无反流，2例轻度反流，2例中度反流，6例重度反流。2例植入主动脉瓣的患者主动脉瓣反流均为重度。我们得出结论，对于临床怀疑人工心脏瓣膜功能障碍的患者，经食管二维成像联合彩色多普勒可提供与手术结果相符的可靠信息。
