Maslow Andrew
Departments of Anesthesiology, Cardiology, and Surgery, Rhode Island Hospital, Providence, RI.
J Cardiothorac Vasc Anesth. 2015 Apr;29(2):439-71. doi: 10.1053/j.jvca.2014.03.013. Epub 2014 Oct 30.
Echocardiographic imaging of the mitral valve before and immediately after repair is crucial to the immediate and long-term outcome. Prior to mitral valve repair, echocardiographic imaging helps determine the feasibility and method of repair. After the repair, echocardiographic imaging displays the new baseline anatomy, assesses function, and determines whether or not further management is necessary. Three-dimensional imaging has improved the assessment of the mitral valve and facilitates communication with the surgeon by providing the surgeon with an image that he/she might see upon opening up the atrium. Further advancements in imaging will continue to improve the understanding of the function and dysfunction of the mitral valve both before and after repair. This information will improve treatment options, timing of invasive therapies, and advancements of repair techniques to yield better short- and long-term patient outcomes. The purpose of this review was to connect the echocardiographic evaluation with the surgical procedure. Bridging the pre- and post-CPB imaging with the surgical procedure allows a greater understanding of mitral valve repair.
二尖瓣修复术前及术后即刻的超声心动图成像对于即刻及长期预后至关重要。在二尖瓣修复术前,超声心动图成像有助于确定修复的可行性及方法。修复术后,超声心动图成像可显示新的基线解剖结构、评估功能,并确定是否需要进一步处理。三维成像改善了对二尖瓣的评估,并通过为外科医生提供打开心房时可能看到的图像,促进了与外科医生的沟通。成像技术的进一步发展将继续提高对二尖瓣修复术前及术后功能及功能障碍的理解。这些信息将改善治疗选择、侵入性治疗的时机以及修复技术的进步,从而为患者带来更好的短期和长期预后。本综述的目的是将超声心动图评估与外科手术联系起来。将体外循环前后的成像与外科手术相结合,有助于更深入地理解二尖瓣修复。