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术中超声心动图在早期检测主动脉瓣置换术后二尖瓣反流中的重要性:病例报告。

The importance of intraoperative echocardiography in the early detection of mitral regurgitation as a postsurgical sequel of aortic valve replacement: a case report.

机构信息

Fellowship of Echocardiography, Department of Cardiology, School of Medicine, Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Cardiovascular Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

出版信息

J Med Case Rep. 2023 Nov 1;17(1):474. doi: 10.1186/s13256-023-04176-6.

Abstract

BACKGROUND

Mitral leaflet perforation (MLP) can rarely be a consequence of aortic valve replacement (AVR), resulting in mitral regurgitation (MR). Determining the cause and severity of MLP following AVR is crucial in preventing hemodynamic consequences, such as pulmonary hypertension and biventricular remodeling. However, the diagnosis of this rare complication requires detailed echocardiographic evaluations.

CASE PRESENTATION

In this paper, we report a 37-year-old Persian male with progressive dyspnea on exertion diagnosed with severe MR caused by anterior MLP following AVR and discuss the importance of intraoperative transesophageal echocardiography (TEE) in the proper and on-time diagnosis of this rare complication.

CONCLUSION

During AVR procedure, an evaluation with TEE could be beneficial for identifying and treating such condition. Echocardiography is beneficial in providing real-time guidance during surgery, early detection of potential complications, treatment of such complications if present, and prevention of adverse outcomes.

摘要

背景

二尖瓣叶穿孔(MLP)很少是主动脉瓣置换术(AVR)的后果,可导致二尖瓣反流(MR)。确定 AVR 后 MLP 的原因和严重程度对于预防肺高压和双心室重构等血流动力学后果至关重要。然而,这种罕见并发症的诊断需要详细的超声心动图评估。

病例介绍

本文报告了一例 37 岁的波斯男性,因 AVR 后前 MLP 导致严重 MR 而出现进行性运动性呼吸困难,并讨论了术中经食管超声心动图(TEE)在正确和及时诊断这种罕见并发症中的重要性。

结论

在 AVR 手术过程中,TEE 评估有助于识别和治疗这种情况。超声心动图在手术过程中提供实时指导、早期发现潜在并发症、治疗现有并发症以及预防不良结局方面具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298b/10619244/380034b330d4/13256_2023_4176_Fig1_HTML.jpg

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