Cha S D, Cha R D, Maranhao V
Department of Cardiology, Deborah Heart and Lung Center, Browns Mills, New Jersey 08015.
Cathet Cardiovasc Diagn. 1991 Sep;24(1):6-9. doi: 10.1002/ccd.1810240103.
To assess the severity of mitral stenosis related to the level of transducers, the mitral valve gradient using pulmonary wedge and left ventricle was obtained from 15 patients. The mitral gradient was obtained with both transducers at mid chest level. Then, the level of each transducer was realigned with the catheter tip in the pulmonary capillary wedge and in the left ventricle using lateral fluoroscopy and the mitral gradient was re-measured. At the mid chest level, the mean mitral valve gradient was 14 +/- 6.2 mm Hg with a mitral valve area of 1.3 +/- 0.6 cm2. With the adjusted level of transducers, the mitral valve gradient was 18.7 +/- 6.8 mm Hg with a valve area of 1.0 +/- 0.5 cm2. The difference was that the level of catheter tip in the wedge was 3.5 cm below the mid chest level and the one in the left ventricle was 2.5 cm higher than the mid chest level. This result suggested that the mitral valve gradient obtained at mid chest level underestimated the severity of mitral stenosis.
为评估与换能器水平相关的二尖瓣狭窄严重程度，从15例患者中获取了使用肺楔压和左心室测得的二尖瓣压差。在胸部中部水平用两个换能器获取二尖瓣压差。然后，使用侧位荧光透视将每个换能器的水平与肺毛细血管楔压和左心室内的导管尖端重新对齐，并重新测量二尖瓣压差。在胸部中部水平，二尖瓣平均压差为14±6.2 mmHg，二尖瓣面积为1.3±0.6 cm²。换能器水平调整后，二尖瓣压差为18.7±6.8 mmHg，瓣膜面积为1.0±0.5 cm²。差异在于楔压中导管尖端水平比胸部中部水平低3.5 cm，左心室内的导管尖端水平比胸部中部水平高2.5 cm。该结果表明，在胸部中部水平测得的二尖瓣压差低估了二尖瓣狭窄的严重程度。
