Kupari M, Harjula A, Mattila S
Br Heart J. 1986 Apr;55(4):364-70. doi: 10.1136/hrt.55.4.364.
Auscultatory and echocardiographic and phonocardiographic studies were performed on 26 patients who had a total of 11 Lillehei-Kaster, 16 Björk-Shiley, and 18 St Jude heart valve prostheses functioning normally in the aortic or mitral positions or both. With all types and positions of prostheses a distinct closing sound was always detected. It was frequently heard in two parts which, according to echocardiographic and phonocardiographic studies, resulted from the onset and completion of the valve closure. An opening sound could be heard from all Björk-Shiley and St Jude valves but from only four of the 11 Lillehei-Kaster valves. The opening sounds due to mitral prostheses consisted of two to three closely spaced clicks detected as a faint early diastolic crackle on auscultation. Echocardiography with phonocardiography indicated that they were related to the onset and termination of the disc opening excursion. In the aortic position the valves always produced early to mid-systolic murmurs, and a soft early diastolic murmur was also heard in seven of 23 patients. A mid-diastolic rumble was heard in 12 of 22 patients with mitral prostheses. Normally functioning tilting disc valve prostheses produce characteristic auscultatory findings, and familiarity with these findings will be useful in clinical evaluation of patients with these prostheses.
对26例患者进行了听诊、超声心动图和心音图研究，这些患者共有11个正常运行于主动脉或二尖瓣位置或两者皆有的 Lillehei-Kaster 心脏瓣膜假体、16个 Björk-Shiley 心脏瓣膜假体和18个 St Jude 心脏瓣膜假体。对于所有类型和位置的假体，总能检测到明显的关闭音。根据超声心动图和心音图研究，它经常分为两部分被听到，这是由瓣膜关闭的开始和结束导致的。所有 Björk-Shiley 和 St Jude 瓣膜都能听到开放音，但11个 Lillehei-Kaster 瓣膜中只有4个能听到。二尖瓣假体产生的开放音由两到三个紧密间隔的喀喇音组成，听诊时可检测为微弱的舒张早期沙沙声。超声心动图结合心音图表明，它们与瓣膜盘开放行程的开始和结束有关。在主动脉位置，瓣膜总是产生收缩早期至中期杂音，23例患者中有7例还听到柔和的舒张早期杂音。22例二尖瓣假体患者中有12例听到舒张中期隆隆声。正常运行的倾斜盘式瓣膜假体产生特征性的听诊表现，熟悉这些表现将有助于对有这些假体的患者进行临床评估。
