Wahl P, Wahl D, Coupillaud J, Flammang D, Waynberger M
Département de cardiologie, Centre hospitalier général d'Angoulême, Saint-Michel.
Arch Mal Coeur Vaiss. 1989 Feb;82(2):251-6.
In a case of acute thrombosis on mitral Starr valve two-dimensional doppler-echocardiography rapidly showed that parts of the transprosthetic jets had disappeared, while conventional continuous wave doppler ultrasound confirmed the presence of a severe haemodynamic obstacle. With colour-coded doppler ultrasound, there only remained a jet that was parallel to the posterior wall of the left ventricle. This jet was of unusual pattern, with the presence of turbulence and high velocities in aliasing colour. The effectiveness of a thrombolytic treatment was demonstrated by the reappearance of the missing diastolic jets with return to normal velocities. Comparison between a post-thrombolysis colour-coded doppler examination and a reference examination confirmed that the valve was now functioning normally. Thus, while conventional doppler recordings accurately quantify prosthetic dysfunctions leading to stenosis, two-dimensional doppler recordings rapidly provide an anatomical information. By showing changes in the transprosthetic jets they indicate the precise location and extent of valve obstruction.
在二尖瓣 Starr 瓣急性血栓形成的病例中，二维多普勒超声心动图迅速显示部分人工瓣膜血流束消失，而传统的连续波多普勒超声证实存在严重的血流动力学障碍。通过彩色编码多普勒超声检查，仅残留一束与左心室后壁平行的血流束。该血流束形态异常，存在湍流且在混叠颜色中具有高流速。溶栓治疗的有效性通过消失的舒张期血流束重新出现且流速恢复正常得以证明。溶栓后彩色编码多普勒检查与参考检查的比较证实瓣膜现在功能正常。因此，虽然传统的多普勒记录能准确量化导致狭窄的人工瓣膜功能障碍，但二维多普勒记录能迅速提供解剖学信息。通过显示人工瓣膜血流束的变化，它们可指示瓣膜梗阻的精确位置和范围。
