Nanda N C, Gramiak R, Shaah P M, DeWese J A
Circulation. 1975 Feb;51(2):263-7. doi: 10.1161/01.cir.51.2.263.
Echocardiographic studies of the mitral valve were performed in 57 patients with pure or predominant mitral stenosis who subsequently underwent surgery (30 commissurotomy, 27 valve replacement). Mitral valve calcification was graded heavy (thick, conglomerate echoes), light (multiple, discrete linear echoes) or none (thin, single or duplicate signals). Valve mobility, measured as the excursion from the systolic closed position to the fully opened position in diastole, was classified as normal (20 mm or over), restricted (16-19 mm) or poor (15 mm or less). Absence of mitral valve caclification was the most useful echocardiographic indicator for commissurotomy (18 of )9 cases. The most reliable criteria for valve replacement were heavy valve calcification (11 of 11 cases) and poor cusp mobility (11 of 11 cases). The poor mobility group included 3 patients with heavily calcified valves. Thus 37 of 57 cases (65%) could be reliably categorized regarding the type of surgery performed using these three parameters. The remaining echocardiographic parameters (normal mobility, restricted mobility and light calcification) were less valuable in the assignment of the operative category. Echocardiographic assessment of mitral valve calcification and mobility appears to be of value in planning the surgical approach in patients with pure or predominant mitral stenosis.
对57例单纯或主要为二尖瓣狭窄且随后接受手术治疗的患者（30例行二尖瓣交界切开术，27例行瓣膜置换术）进行了二尖瓣超声心动图检查。二尖瓣钙化分为重度（厚的、聚集的回声）、轻度（多个离散的线性回声）或无（薄的、单个或重复信号）。瓣膜活动度通过从收缩期关闭位置到舒张期完全开放位置的移动距离来测量，分为正常（20毫米或以上）、受限（16 - 19毫米）或差（15毫米或以下）。二尖瓣无钙化是二尖瓣交界切开术最有用的超声心动图指标（9例中有18例）。瓣膜置换最可靠的标准是重度瓣膜钙化（11例中有11例）和瓣叶活动度差（11例中有11例）。活动度差的组包括3例瓣膜重度钙化的患者。因此，利用这三个参数，57例中的37例（65%）能够可靠地分类所施行的手术类型。其余的超声心动图参数（活动度正常、活动度受限和轻度钙化）在确定手术类别方面价值较小。二尖瓣钙化和活动度的超声心动图评估在规划单纯或主要为二尖瓣狭窄患者的手术方法时似乎具有价值。
