Morocutti G, Gelsomino S, Spedicato L, Frassani R, Bernardi G, Da Col P, Paparella G, Fioretti P, Livi U
Department of Cardiovascular Sciences, General Hospital S. Maria della Misericordia, Udine, Italy.
Cardiovasc Surg. 2002 Aug;10(4):328-32. doi: 10.1016/s0967-2109(02)00019-4.
The aim of this study was to assess the utility of intraoperative transesophageal echocardiography (TEE) in the evaluation of patients undergoing aortic valve replacement with the CryoLife-O'Brien (CLOB) Stentless Porcine Aortic Bioprosthesis.
Between May 1994 and March 1995, 26 patients (15 men, mean age 68.4+/-10.78 years) had a CLOB valve in the aortic position. Transprosthetic gradients and valve regurgitation were detected by intraoperative TEE. Prosthetic regurgitation and transvalvular gradients were evaluated at six-month intervals using transthoracic echo-Doppler (TTE).
The majority of implants resulted in low gradients (83.7%), with only four patients exhibiting a moderate gradient (15.3%). Color flow Doppler imaging showed central aortic regurgitation in only four of 25 patients (trivial, n=4; mild, n=1). There was one paravalvular leak (trivial, n=1). At follow-up examination (mean 37+/-12 months), 24 of 25 patients exhibited low mean gradients (7.25+/-2.81 mmHg). At follow-up one patient who had low velocities in the LVOT at perioperative evaluation exibited a moderate gradient (45 mmHg) with an effective orifice area of 0.8-0.9 cm(2).
Intraoperative TEE was effective in assessing prosthetic stentless valve function.
本研究的目的是评估术中经食管超声心动图（TEE）在评价接受使用CryoLife - O'Brien（CLOB）无支架猪主动脉生物瓣膜进行主动脉瓣置换术患者中的应用价值。
1994年5月至1995年3月期间，26例患者（15例男性，平均年龄68.4±10.78岁）在主动脉位置植入了CLOB瓣膜。术中通过TEE检测跨瓣膜压差和瓣膜反流情况。使用经胸超声多普勒（TTE）每隔6个月评估人工瓣膜反流和跨瓣膜压差。
大多数植入导致低压差（83.7%），只有4例患者表现为中度压差（15.3%）。彩色血流多普勒成像显示25例患者中仅4例存在中心主动脉反流（微量，n = 4；轻度，n = 1）。有1例瓣周漏（微量，n = 1）。在随访检查（平均37±12个月）时，25例患者中有24例表现为低平均压差（7.25±2.81 mmHg）。在随访中，1例在围手术期评估时左心室流出道流速较低的患者表现为中度压差（45 mmHg），有效瓣口面积为0.8 - 0.9 cm²。
术中TEE在评估人工无支架瓣膜功能方面是有效的。
