Assanelli D, Aquilina M, Marangoni S, Morgagni G L, Visioli O
Am J Cardiol. 1986 Jan 1;57(1):165-70. doi: 10.1016/0002-9149(86)90973-2.
Ninety patients were studied with combined echophonocardiography after Björk-Shiley disc prosthetic mitral valve replacement. They were evaluated every 6 months (mean follow-up 6 years). Nine cases of left ventricular (LV) failure and 6 cases of prosthetic malfunction (5 paravalvular leaks and 1 thrombosis) were detected; 1 case was confirmed at necropsy and the other 5 cases were surgically verified and repaired. The following measures of prosthetic malfunction were evaluated: opening and closing velocity, maximal amplitude of the prosthesis, septal motion 6 months after operation, LV diastolic diameter, protodiastolic hump, variations during same record of the interval between aortic valve closure sound to the phono and mitral valve opening to the echo, and interval between aortic valve closure sound and maximal excursion of the LV posterior wall. All measures studied were useful for detecting prosthetic malfunction, but 2 are more useful in individual cases: variations of the interval between second heart sound and mitral valve opening and the interval between the aortic valve closure sound and LV posterior wall motion. These 2 intervals also allow discrimination between normal function, prosthetic malfunction and LV failure.
对90例接受了比约克-希利碟片式人工二尖瓣置换术的患者进行了联合超声心动图检查。每6个月对他们进行评估（平均随访6年）。检测到9例左心室（LV）衰竭和6例人工瓣膜功能障碍（5例瓣周漏和1例血栓形成）；1例在尸检时得到证实，其他5例经手术证实并修复。评估了以下人工瓣膜功能障碍的指标：开闭速度、人工瓣膜的最大幅度、术后6个月的室间隔运动、左心室舒张直径、舒张早期隆起、在同一记录中从主动脉瓣关闭音到心音以及二尖瓣开放到回声之间的间期变化，以及主动脉瓣关闭音与左心室后壁最大运动之间的间期。所研究的所有指标都有助于检测人工瓣膜功能障碍，但有2个指标在个别病例中更有用：第二心音与二尖瓣开放之间的间期变化以及主动脉瓣关闭音与左心室后壁运动之间的间期。这2个间期还可以区分正常功能、人工瓣膜功能障碍和左心室衰竭。
