Cohen J L, Austin S M, Kim C S, Christakos M E, Hussain S M
Am Heart J. 1984 Jan;107(1):108-12. doi: 10.1016/0002-8703(84)90142-x.
Aortic root diameter was measured by two-dimensional (2DE) and M-mode echocardiography in 20 adult patients (aged 29 to 69 years) undergoing aortic valve replacement in order to predict prosthetic aortic valve size. Eight patients had predominantly aortic stenosis, six had chronic aortic regurgitation, and six had acute severe aortic regurgitation secondary to infective endocarditis. 2DE measurements of aortic anulus diameter, as determined from the parasternal long-axis view, demonstrated a high correlation with actual prosthetic valve size implanted at surgery (r = 0.89, p less than 0.001, SEE 0.68 mm). 2DE exactly predicted actual prosthetic valve size in 12 of 20 patients (60%), was within 1 mm of prosthetic valve size in 6 of 20 patients (30%), and was within 2 mm of prosthetic valve size in two patients. In contrast, M-mode echocardiography failed to significantly predict aortic valve size (r = 0.14) because of its lack of two-dimensional anatomic orientation. Thus 2DE can safely and accurately predict preoperatively prosthetic aortic valve size and thereby be of great value in helping to avoid the problem of prosthesis-patient mismatch.
对20例接受主动脉瓣置换术的成年患者（年龄29至69岁）进行二维（2DE）和M型超声心动图检查，以测量主动脉根部直径，从而预测人工主动脉瓣大小。8例患者主要为主动脉瓣狭窄，6例为慢性主动脉瓣关闭不全，6例为继发于感染性心内膜炎的急性重度主动脉瓣关闭不全。从胸骨旁长轴视图确定的主动脉瓣环直径的2DE测量结果显示，与手术中植入的实际人工瓣膜大小高度相关（r = 0.89，p小于0.001，标准估计误差0.68 mm）。2DE在20例患者中的12例（60%）中准确预测了实际人工瓣膜大小，在20例患者中的6例（30%）中与人工瓣膜大小相差在1 mm以内，在2例患者中与人工瓣膜大小相差在2 mm以内。相比之下，M型超声心动图由于缺乏二维解剖定位，未能显著预测主动脉瓣大小（r = 0.14）。因此，2DE能够安全、准确地术前预测人工主动脉瓣大小，从而在帮助避免人工瓣膜与患者不匹配问题方面具有重要价值。
