Yared Kibar, Solis Jorge, Passeri Jonathan, King Mary Etta E, Levine Robert A
Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
J Am Soc Echocardiogr. 2009 Apr;22(4):435.e1-3. doi: 10.1016/j.echo.2008.12.026. Epub 2009 Feb 8.
A 60-year-old man was readmitted 1 year after bioprosthetic aortic valve replacement for recurrent endocarditis. Transthoracic 2-dimensional color Doppler revealed a novel finding of a left-to-right shunt from the left ventricular outflow tract to the right atrium immediately superior to the septal leaflet of the tricuspid valve consistent with an acquired Gerbode defect. Real-time 3-dimensional echocardiography was used to accurately delineate the course of the shunt. To avoid overestimating right ventricular systolic pressure by mistaking such a shunt for an eccentric jet of tricuspid regurgitation, it is important to accurately differentiate the two. Real-time 3-dimensional echocardiography now provides rapid, detailed 3-dimensional appreciation of the origin and course of such shunts with easy facility of orienting views to the flows of interest by cropping. Such information can help design optimal surgical or catheter-based therapy.
一名60岁男性在生物人工主动脉瓣置换术后1年因复发性心内膜炎再次入院。经胸二维彩色多普勒显示了一个新发现，即从左心室流出道到紧邻三尖瓣隔叶上方的右心房存在左向右分流，符合后天性Gerbode缺损。实时三维超声心动图用于准确描绘分流路径。为避免将此类分流误认作三尖瓣反流的偏心射流而高估右心室收缩压，准确区分两者很重要。实时三维超声心动图现在能够快速、详细地提供此类分流的起源和路径的三维图像，通过裁剪可轻松将感兴趣的血流视图定向。这些信息有助于设计最佳的手术或导管介入治疗方案。
