Cormier B, Starkman C, Enriquez-Sarano M, Vitoux B, Kulas A, Dewilde J, Grimberg D, Acar J
Service de cardiologie, Hôpital Tenon, Paris.
Arch Mal Coeur Vaiss. 1990 Mar;83(3):345-50.
The aim of this study was to determine the reliability of preoperative transthoracic and transesophageal echocardiography compared with the surgical findings in pure or dominant severe mitral regurgitation with respect to: the evaluation of the lesions, mechanism and etiology; the provision of the type of surgery (valve replacement or reconstruction); One hundred and fifty patients were divided into two groups: Group I (N = 120) in which preoperative assessment included transthoracic echo-Doppler coupled with color Doppler in the last 32 patients; Group II (N = 30) operated recently who underwent both transesophageal and transthoracic echo-Doppler examination. In Group I, the sensitivity of transthoracic echo in the evaluation of the etiological was 86% overall [100% in rheumatic valve disease (N = 28), 86% in degenerative or dystrophic valves (N = 72), 44% in endocarditis (N = 9), 87% in ischaemic dysfunction (N = 8)]. The echo evaluation of the mechanism of the regurgitation was also reliable with the exception of ruptured chordae in which direct visualisation of the rupture was only possible in 19 of the 64 cases (30%). The type of surgery predicted by echo was practiced in 87% of cases.
本研究的目的是确定在单纯性或主要为重度二尖瓣反流中，术前经胸和经食管超声心动图与手术结果相比在以下方面的可靠性：病变、机制和病因的评估；手术类型（瓣膜置换或重建）的提供。150例患者分为两组：第一组（N = 120），其中术前评估包括经胸回声多普勒检查，最近32例患者还进行了彩色多普勒检查；第二组（N = 30）为近期接受手术的患者，他们同时接受了经食管和经胸回声多普勒检查。在第一组中，经胸回声在病因评估中的总体敏感性为86%[风湿性瓣膜病（N = 28）中为100%，退行性或营养不良性瓣膜（N = 72）中为86%，心内膜炎（N = 9）中为44%，缺血性功能障碍（N = 8）中为87%]。除腱索断裂外，反流机制的回声评估也可靠，在64例腱索断裂病例中，只有19例（30%）能够直接观察到断裂情况。回声预测的手术类型在87%的病例中得到实施。
