Jiang L
Shanghai Institute of Cardiovascular Diseases, Zhong Shan Hospital, Shanghai Medical University.
Zhonghua Xin Xue Guan Bing Za Zhi. 1990 Aug;18(4):195-7, 252.
To assess the value of intraoperative transesophageal echocardiographical Doppler color flow imaging (TEE-DCFI) during cardiac valvular surgery, 85 consecutive patients with 102 diseased valves for surgery were studied with pre-and post-operative TEE-DCFI. There were 34 women and 51 men with an age range of 15 to 55 years (mean age, 34.91 +/- 9.33 years). The etiology of valve lesion was rheumatic in 57 (AV 10, MV 47), prolapse in 9 (AV 2, MV 7), endocarditis in 21 (AV 12, MV 3, PV 2, prosthetic infection 4), prosthetic dysfunction in 14 (AV 5, MV 9), congenital in 1 (TV). Preoperative TEE-DCFI findings were helpful either in completing with some new information or changing the operation plan in 29 valves (28.43%) including abscess at aortic root in 1, perforation of aortic valve in 2, perforation of mitral valve leaflets in 5 patients with aortic valvular endocarditis, regurgitation or perivalvular leak of prosthetic valve in 4 MVs and 4AVs, left atrial thrombus detected in 8 and excluded in 3 patients with MV disease, small calcified vegetation on PV with normal valve function in 2 patients with congenital heart disease. Postoperative TEE-DCFI evaluation was performed in 53 patients with 70 diseased valves. There was only one mild regurgitation of mitral bioprosthesis and one mild perivalvular leak of aortic prosthesis detected among 40 replaced prosthetic valves. Of 30 valves repaired 23 (77%) valves had trivial or mild residual regurgitation (Group A) and 7 (23%) had moderate residual regurgitation (Group B). Postoperative congestive heart failure was seen in 6 (26.09%) of Group A and 5 (71.43%) of Group B (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
为评估术中经食管超声心动图彩色多普勒血流成像（TEE-DCFI）在心脏瓣膜手术中的价值，对85例连续行102个病变瓣膜手术的患者进行了术前和术后TEE-DCFI研究。其中女性34例，男性51例，年龄15至55岁（平均年龄34.91±9.33岁）。瓣膜病变病因包括风湿性57例（主动脉瓣10例，二尖瓣47例）、脱垂9例（主动脉瓣2例，二尖瓣7例）、心内膜炎21例（主动脉瓣12例，二尖瓣3例，肺动脉瓣2例，人工瓣膜感染4例）、人工瓣膜功能障碍14例（主动脉瓣5例，二尖瓣9例）、先天性1例（三尖瓣）。术前TEE-DCFI检查结果有助于补充新信息或改变手术方案的有29个瓣膜（28.43%），包括主动脉根部脓肿1例、主动脉瓣穿孔2例、5例主动脉瓣心内膜炎患者二尖瓣叶穿孔、4个二尖瓣和4个主动脉瓣人工瓣膜反流或瓣周漏、8例二尖瓣病变患者发现左心房血栓，3例排除、2例先天性心脏病患者肺动脉瓣有小钙化赘生物但瓣膜功能正常。53例患者70个病变瓣膜进行了术后TEE-DCFI评估。40个置换人工瓣膜中仅发现1例二尖瓣生物瓣轻度反流和1例主动脉瓣人工瓣膜轻度瓣周漏。30个修复瓣膜中，23个（77%）瓣膜有微量或轻度残余反流（A组），7个（23%）有中度残余反流（B组）。A组6例（26.09%）、B组5例（71.43%）出现术后充血性心力衰竭（P<0.05）。（摘要截短于250字）
