Langerveld Jorina, Valocik Gabriel, Plokker H W Thijs, Ernst Sjef M P G, Mannaerts Herman F J, Kelder Johannes C, Kamp Otto, Jaarsma Wybren
Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands.
J Am Soc Echocardiogr. 2003 Aug;16(8):841-9. doi: 10.1067/S0894-7317(03)00402-4.
The objective of this study was to validate the additional value of 3-dimensional (3D) transesophageal echocardiography (TEE) for patients with mitral valve stenosis undergoing percutaneous mitral balloon valvotomy (PTMV). Therefore, in a series of 21 patients with severe mitral valve stenosis selected for PTMV, 3D TEE was performed before and after PTMV. The mitral valve area was assessed by planimetry pre- and post-PTMV; the mitral valve volume was assessed and attention was paid to the amount of fusion of the commissures. These results were compared with findings by 2-dimensional transthoracic echocardiography using pressure half-time method for assessment of mitral valve area, and were analyzed for the prediction of successful outcome. Pre-PTMV the mitral valve area assessed by 3D TEE was 1.0 +/- 0.3 cm(2) vs 1.2 +/- 0.4 cm(2) assessed by 2-dimensional transthoracic echocardiography (P =.03) and post-PTMV it was 1.8 +/- 0.5 cm(2) vs 1.9 +/- 0.6 cm(2) (not significant), respectively. The mitral valve volume could be assessed by 3D TEE (mean 2.4 +/- 2.5 cm(3)) and was inversely correlated to a successful PTMV procedure (P <.001). The 3D TEE method enabled a better description of the mitral valvular anatomy, especially post-PTMV. We conclude that 3D TEE will have additional value over 2-dimensional echocardiography in this group of patients, for selection of patients pre-PTMV, and for analyzing pathology of the mitral valve afterward.
本研究的目的是验证三维（3D）经食管超声心动图（TEE）对接受经皮二尖瓣球囊成形术（PTMV）的二尖瓣狭窄患者的附加价值。因此，在一系列21例因PTMV入选的重度二尖瓣狭窄患者中，于PTMV前后进行了3D TEE检查。通过面积测量法评估PTMV前后的二尖瓣面积；评估二尖瓣容积，并关注瓣叶融合程度。将这些结果与采用压力减半时间法评估二尖瓣面积的二维经胸超声心动图检查结果进行比较，并分析其对手术成功结果的预测情况。PTMV前，3D TEE评估的二尖瓣面积为1.0±0.3 cm²，而二维经胸超声心动图评估的为1.2±0.4 cm²（P = 0.03）；PTMV后，3D TEE评估的二尖瓣面积为1.8±0.5 cm²，二维经胸超声心动图评估的为1.9±0.6 cm²（无显著差异）。3D TEE可评估二尖瓣容积（平均2.4±2.5 cm³），且与PTMV手术成功呈负相关（P < 0.001）。3D TEE方法能更好地描述二尖瓣解剖结构，尤其是PTMV后。我们得出结论，在这类患者中，3D TEE在PTMV术前患者选择及术后二尖瓣病变分析方面比二维超声心动图具有附加价值。
