术中实时三维经食管超声心动图在心脏手术中的应用价值
Usefulness of intraoperative real-time 3D transesophageal echocardiography in cardiac surgery.
作者信息
Scohy Thierry V, Ten Cate Folkert J, Lecomte Patrick V E L, McGhie Jackie, de Jong Peter L, Hofland Jan, Bogers Ad J J C
机构信息
Department of Anaesthesiology, Erasmus Medical Center, Rotterdam, The Netherlands.
出版信息
J Card Surg. 2008 Nov-Dec;23(6):784-6. doi: 10.1111/j.1540-8191.2008.00666.x.
BACKGROUND
Recent advances in three-dimensional (3D) echocardiography allow to obtain real-time 3D transesophageal (RT3DTEE) images intraoperatively.
METHODS
Preoperative transthoracic echocardiography (TTE) revealed: hypertrophic ventricular septum (TTE:19.3 mm), systolic anterior motion (SAM) not causing obstruction and malcoaptation of the anterior mitral valve leaflet (AMVL), and posterior mitral valve leaflet (PMVL) with severe mitral regurgitation.
RESULTS
Intraoperative TEE with a x7-2t MATRIX-array transducer (Philips, Andover, MA, USA) with a transducer frequency of x7-2 t mHz, connected to a iE33 (Philips), shows us that the main mechanism and site of regurgitation was an AMVL cleft. We also measured a 24.3-mm thickness of the ventricular septum and analyzing the 3D full volume acquisition revealed that there was no SAM.
CONCLUSION
Intraoperative RT3DTEE permitted comprehensive 3D viewing of the mitral valve revealing the mechanism of mitral valve regurgitation, SAM, and the exact width of the hypertrophic ventricular septum.
背景
三维（3D）超声心动图的最新进展使得术中能够获取实时三维经食管（RT3DTEE）图像。
方法
术前经胸超声心动图（TTE）显示：室间隔肥厚（TTE：19.3 mm），收缩期前向运动（SAM）未导致梗阻，二尖瓣前叶（AMVL）与后叶（PMVL）对合不良，伴有严重二尖瓣反流。
结果
术中使用连接到iE33（飞利浦）的频率为x7 - 2 t mHz的x7 - 2t MATRIX阵列换能器（美国马萨诸塞州安多弗市飞利浦公司）进行经食管超声心动图检查，结果显示反流的主要机制和部位是AMVL裂。我们还测量了室间隔厚度为24.3 mm，分析三维全容积采集结果显示不存在SAM。
结论
术中RT3DTEE能够对二尖瓣进行全面的三维观察，揭示二尖瓣反流的机制、SAM以及肥厚室间隔的确切宽度。
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