以充血性心力衰竭为表现的二尖瓣瓣周漏，经胸超声心动图漏诊但经食管超声心动图确诊：一例病例报告
Paravalvular mitral valve leakage presenting as congestive heart failure, missed by TTE but diagnosed by TEE: a case report.
作者信息
Jayawardena Suriya, Sooriabalan Danushan, Burzyantseva Olga, Sinnapunayagm Selvaratnam
机构信息
Coney Island Hospital, 2601 Ocean Park Way, Brooklyn, NY 11235, USA.
出版信息
Cases J. 2008 Oct 6;1(1):216. doi: 10.1186/1757-1626-1-216.
BACKGROUND
Diagnosis of prosthetic valve leakage by the transthoracic echocardiogram (TTE) technique is more difficult. These limitations are diminished with the use of transesophageal echocardiogram (TEE) techniques.
CASE REPORT
A 71 year old Caucasian male presented with symptoms and signs of congestive heart failure. Past medical history included a bio-prosthetic mitral valve replacement for severe mitral regurgitation. TTE showed possible mitral regurgitation. As the TTE did not correlate with the finding of a high E-velocity, a TEE was performed, which showed a significant paravalvular leak of moderate severity around the bio-prosthetic mitral valve.
CONCLUSION
There should be a high degree of suspicion to diagnose a paravalvular leak.
背景
经胸超声心动图（TTE）技术诊断人工瓣膜渗漏较为困难。使用经食管超声心动图（TEE）技术可减少这些局限性。
病例报告
一名71岁的白种男性出现充血性心力衰竭的症状和体征。既往病史包括因严重二尖瓣反流进行生物人工二尖瓣置换术。TTE显示可能存在二尖瓣反流。由于TTE结果与高E速度的发现不相关，遂进行了TEE检查，结果显示生物人工二尖瓣周围存在中度严重程度的明显瓣周漏。
结论
诊断瓣周漏时应高度怀疑。
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