Nowrangi S K, Connolly H M, Freeman W K, Click R L
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn. 55905, USA.
J Am Soc Echocardiogr. 2001 Sep;14(9):863-6. doi: 10.1067/mje.2001.113368.
In this study, we sought to define the impact of intraoperative transesophageal echocardiography (IOTEE) among patients undergoing aortic valve replacement for severe aortic stenosis. We reviewed the clinical data and preoperative, intraoperative, and postoperative echocardiograms of all adults who underwent aortic valve replacement for aortic stenosis and had IOTEE between January 1993 and December 1996. There were 383 patients (223 men, 160 women; mean age, 69 years). Fifty-four (14%) of the 383 patients had mitral valve surgery at the time of aortic valve replacement. In 6 patients, mitral valve surgery was not planned but was added because of findings on IOTEE. In 25 patients, mitral valve surgery was canceled on the basis of the IOTEE. Additional information was found by IOTEE in 25 patients before and after bypass, altering the surgical plan in 18 of these 25 patients. Overall, IOTEE altered the planned operation in 49 (13%) of the 383 patients. These data support the routine use of IOTEE among patients undergoing aortic valve replacement for aortic stenosis.
在本研究中，我们试图确定术中经食管超声心动图（IOTEE）对重度主动脉瓣狭窄患者行主动脉瓣置换术的影响。我们回顾了1993年1月至1996年12月期间所有因主动脉瓣狭窄行主动脉瓣置换术并接受IOTEE检查的成年人的临床资料以及术前、术中和术后的超声心动图。共有383例患者（223例男性，160例女性；平均年龄69岁）。383例患者中有54例（14%）在主动脉瓣置换术时同时进行了二尖瓣手术。在6例患者中，二尖瓣手术并非计划内，但因IOTEE检查结果而加做。在25例患者中，二尖瓣手术根据IOTEE检查结果被取消。IOTEE在25例患者体外循环前后发现了其他信息，其中18例患者的手术计划因此改变。总体而言，IOTEE改变了383例患者中49例（13%）的计划手术。这些数据支持在因主动脉瓣狭窄行主动脉瓣置换术的患者中常规使用IOTEE。
