Aoyagi Shigeaki, Tomoeda Hiroshi, Kawano Hiroshi, Yokose Shogo, Fukunaga Shuji
Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
Asian Cardiovasc Thorac Ann. 2003 Sep;11(3):193-7. doi: 10.1177/021849230301100302.
Doppler echocardiographic characteristics of 29 normally functioning prosthetic valves (23 mechanical, 6 biological) and 8 obstructed mechanical prostheses in the tricuspid position are reported. In normally functioning prostheses, peak velocity, mean pressure gradient, and pressure-half time were 1.25 +/- 0.18 m x sec(-1), 2.6 +/- 1.1 mm Hg, and 122.6 +/- 30.7 msec, respectively. Although no significant differences were seen in peak velocity and mean pressure gradient between mechanical and biological valves, the pressure half-time was significantly greater in biological valves. All normally functioning prostheses had a mean pressure gradient 5.5 mm Hg and pressure half-time < 200 msec. In obstructed bileaflet valves, peak velocity was 1.66 +/- 0.28 m x sec(-1), mean pressure gradient was 6.1 +/- 2.8 mm Hg, and pressure half-time was 265.8 +/- 171.7 msec. These Doppler data were significantly greater than those in normally functioning valves where the mean pressure gradient was 5.1 mm Hg and the pressure half-time was 156 msec in all except one patient. Pathological obstruction of a tricuspid prosthesis can be strongly suspected in patients with a mean pressure gradient > 5.5 mm Hg and a pressure half-time > 200 msec on Doppler echocardiography.
本文报告了29个功能正常的人工瓣膜（23个机械瓣，6个生物瓣）及8个三尖瓣位梗阻性机械瓣的多普勒超声心动图特征。功能正常的人工瓣膜，峰值流速、平均压力阶差和压力减半时间分别为1.25±0.18m·sec⁻¹、2.6±1.1mmHg和122.6±30.7msec。虽然机械瓣和生物瓣在峰值流速和平均压力阶差上无显著差异，但生物瓣的压力减半时间显著更长。所有功能正常的人工瓣膜平均压力阶差＜5.5mmHg，压力减半时间＜200msec。在梗阻性双叶瓣中，峰值流速为1.66±0.28m·sec⁻¹，平均压力阶差为6.1±2.8mmHg，压力减半时间为265.8±171.7msec。这些多普勒数据显著高于功能正常瓣膜，功能正常瓣膜平均压力阶差为5.1mmHg，除1例患者外压力减半时间为156msec。对于多普勒超声心动图检查平均压力阶差＞5.5mmHg且压力减半时间＞200msec的患者，强烈怀疑存在三尖瓣人工瓣膜的病理性梗阻。
