Roudaut R, Gosse P, Basto L, Reynaud P, Leherissier A, Dallocchio M
Hôpital cardiologique du Haut-Lévêque, centre hospitalier et universitaire de Bordeaux, Pessac.
Arch Mal Coeur Vaiss. 1990 Aug;83(9):1417-22.
The diagnosis of thrombosis of a valvular prosthesis is difficult especially in cases of partial thrombosis. The authors report 19 cases of partial thrombosis of mainly (16 cases) mechanical valve prostheses confirmed by radioscopy and treated either by reoperation or fibrinolysis. Mitral Valve Prostheses: 14 cases (6 Björk, 7 SJM, 1 Carbomedics). All but one case showed significant prolongation of the pressure half time compared with the postoperative reference value. In one case, however, the functional parameters of the prosthesis were normal; the diagnosis was made from the finding of a mobile thrombus on the ventricular surface of the prosthesis. Aortic Valve Prostheses: 5 cases (3 Björk, 1 SJM, 1 Duromedics). Continuous wave Doppler showed significant increases in the velocity of transprosthetic blood flow with respect to the postoperative reference values. Accurate analysis of the mobile elements of the prostheses was usually impossible. These results show that transthoracic Doppler echocardiography remains an excellent method of study and surveillance of mechanical valve prostheses but the limitations of the technique should be familiar to all operators.
人工瓣膜血栓形成的诊断很困难，尤其是在部分血栓形成的病例中。作者报告了19例主要为（16例）机械瓣膜假体部分血栓形成的病例，这些病例经透视证实，并通过再次手术或纤维蛋白溶解治疗。二尖瓣假体：14例（6例Björk，7例SJM，1例Carbomedics）。除1例外，所有病例与术后参考值相比，压力半衰期均显著延长。然而，有1例假体的功能参数正常；诊断是根据在假体心室表面发现活动血栓做出的。主动脉瓣假体：5例（3例Björk，1例SJM，1例Duromedics）。连续波多普勒显示，与术后参考值相比，经假体的血流速度显著增加。通常无法对假体的活动成分进行准确分析。这些结果表明，经胸多普勒超声心动图仍然是研究和监测机械瓣膜假体的一种优秀方法，但所有操作人员都应熟悉该技术的局限性。
