Wei Jeng, Hsiung Ming C, Tsai Shen Kou, Ou Ching-Huei, Chang Chung-Yi, Chang Yi Cheng, Lee Kuo Chen, Sue Sung-How, Chou Yi-Pen
Division of Cardiovascular Diseases, Cheng-Hsin General Hospital, No 45, Cheng Hsin St, Beitou, Taipei, Taiwan.
Eur J Echocardiogr. 2010 Jan;11(1):14-8. doi: 10.1093/ejechocard/jep173. Epub 2009 Nov 21.
Perioperative monitoring of mitral valve (MV) anatomy, function, and pathology is essential for surgical management of different MV disease.
To overcome the several potential pitfalls of two-dimensional transesophageal echocardiography (2D TEE) and offline 3D TEE.
Live 3D TEE was used to assess 73 patients (44 men and 29 women) with Carpentier type II MV regurgitation undergoing MV surgery perioperatively.
The isolated segment most frequently involved was A2/P2, but A1or P1 rarely was involved in an isolated lesion or combined lesions. The agreement between 3D TEE finding and surgery was 88% (64/73). In nine patients, the live 3D TEE images revealed more segments or scallops with prolapse than the surgeon noted intraoperatively.
Live 3D TEE allows more sensitivity and was feasible identification of prolapse or flail of individual segments of MV leaflets during surgery. We conclude that live 3D TEE should be regarded as an important adjunct to the standard 2D TEE examination in making decisions about MV surgery.
二尖瓣（MV）解剖结构、功能及病理改变的围手术期监测对于不同二尖瓣疾病的手术治疗至关重要。
克服二维经食管超声心动图（2D TEE）和离线三维经食管超声心动图（3D TEE）的一些潜在缺陷。
采用实时三维经食管超声心动图（Live 3D TEE）对73例接受二尖瓣手术的Carpentier II型二尖瓣反流患者（44例男性，29例女性）进行围手术期评估。
最常受累的孤立节段是A2/P2，但A1或P1很少单独受累或合并其他病变。三维经食管超声心动图检查结果与手术结果的一致性为88%（64/73）。9例患者中，实时三维经食管超声心动图显示脱垂的节段或扇贝形结构比术者术中观察到的更多。
实时三维经食管超声心动图在手术过程中对二尖瓣叶单个节段的脱垂或连枷样改变具有更高的敏感性，且可行。我们得出结论，在二尖瓣手术决策中，实时三维经食管超声心动图应被视为标准二维经食管超声心动图检查的重要辅助手段。
