Martin G R, Galioto F M, Midgley F M
Department of Cardiology, Children's Hospital National Medical Center, Washington, DC 20010.
Am J Cardiol. 1989 Apr 15;63(13):964-8. doi: 10.1016/0002-9149(89)90149-5.
To determine the Doppler characteristics of tilting-disc prosthetic heart valves in children, 22 children with mitral prostheses were studied 8 +/- 2 months after surgery, and 10 children with aortic prostheses were studied 37 +/- 26 months after surgery. All valves were thought to be functioning normally by clinical examination. Valve competence was interrogated and peak and mean velocities were measured by standard pulsed wave, continuous wave and color Doppler techniques. Prosthetic valve area was calculated and compared to the known valve area. Mild prosthetic valve regurgitation was present in 8 of 22 mitral and 7 of 10 aortic prostheses. For mitral prostheses, peak velocity was 192 +/- 41 cm/s, mean velocity was 118 +/- 37 cm/s and mean gradient was 7 +/- 4 mm Hg. For aortic prostheses, peak velocity was 287 +/- 88 cm/s, mean velocity was 197 +/- 59 cm/s, peak gradient was 36 +/- 21 mm Hg and mean gradient was 19 +/- 11 mm Hg. Prosthetic mitral valve area, calculated by the pressure half-time and modified Gorlin methods, correlated well with the known valve area (r = 0.89, standard error of the estimate = 0.29 and r = 0.95, standard error of the estimate = 0.21, respectively). Prosthetic aortic valve area, calculated by the modified Gorlin method, correlated well with the known valve area (r = 0.89, standard error of the estimate = 0.18). Residual valvular abnormalities are common after prosthetic valve insertion in children. Doppler estimates of prosthetic valve area correlate well with the known valve area but have a large standard error of the estimate.
为确定儿童倾斜碟片人工心脏瓣膜的多普勒特征，对22例接受二尖瓣置换术的儿童在术后8±2个月进行了研究，对10例接受主动脉瓣置换术的儿童在术后37±26个月进行了研究。通过临床检查，所有瓣膜均被认为功能正常。采用标准脉冲波、连续波和彩色多普勒技术检测瓣膜功能并测量峰值和平均速度。计算人工瓣膜面积并与已知瓣膜面积进行比较。22个二尖瓣人工瓣膜中有8个、10个主动脉瓣人工瓣膜中有7个存在轻度人工瓣膜反流。对于二尖瓣人工瓣膜，峰值速度为192±41cm/s，平均速度为118±37cm/s，平均压差为7±4mmHg。对于主动脉瓣人工瓣膜，峰值速度为287±88cm/s，平均速度为197±59cm/s，峰值压差为36±21mmHg，平均压差为19±11mmHg。通过压力减半时间法和改良戈林法计算的人工二尖瓣面积与已知瓣膜面积相关性良好（相关系数分别为r = 0.89，估计标准误 = 0.29和r = 0.95，估计标准误 = 0.21）。通过改良戈林法计算的人工主动脉瓣面积与已知瓣膜面积相关性良好（r = 0.89，估计标准误 = 0.18）。儿童人工瓣膜置换术后残余瓣膜异常很常见。人工瓣膜面积的多普勒估计值与已知瓣膜面积相关性良好，但估计标准误较大。
