Demetrio Pittarello, Andrea Colli, Gianclaudio Falasco, Antonio Marcassa, Gino Gerosa, Carlo Ori
Department of Medicine, Anesthesia and Intensive Care Unit, University of Padova, Padova, Italy.
Ann Card Anaesth. 2015 Apr-Jun;18(2):191-7. doi: 10.4103/0971-9784.154473.
Transapical off-pump mitral valve intervention with neochord implantation for degenerative mitral valve disease have been recently introduced in the surgical practice. The procedure is performed under 2D-3D transesophageal echocardiography guidance.
The use of 3D real-time transesophageal echocardiography provides more accurate information than 2D echocardiography only in all the steps of the procedure. In particular 3D echocardiography is mandatory for preoperative assessment of the morphology of the valve, for correct positioning of the neochord on the diseased segment , for the final tensioning of the chordae and for the final evaluation of the surgical result.
This article is to outline the technical aspects of the transesophageal echocardiography guidance of the NeoChord procedure showing that the procedure can be performed only with a close and continuous interaction between the anesthesiologist and the cardiac surgeon.
经心尖非体外循环二尖瓣置换术联合新腱索植入治疗退行性二尖瓣疾病最近已被引入外科手术实践。该手术在二维-三维经食管超声心动图引导下进行。
在手术的所有步骤中，使用三维实时经食管超声心动图比仅使用二维超声心动图能提供更准确的信息。特别是，三维超声心动图对于术前评估瓣膜形态、将新腱索正确定位在病变节段、腱索的最终张紧以及手术结果的最终评估是必不可少的。
本文旨在概述经食管超声心动图引导下新腱索手术的技术要点，表明该手术仅在麻醉医生和心脏外科医生密切且持续的互动下才能进行。
