DePace N L, Kotler M N, Mintz G S, Lichtenberg R, Goel I P, Segal B L
Chest. 1981 Sep;80(3):272-7. doi: 10.1378/chest.80.3.272.
Forty-three consecutive patients with a St. Jude mitral, aortic, or combined prosthesis were studied by simultaneous phonocardiography and echocardiography. Twenty-eight patients had a mitral prosthesis, 20 an aortic prosthesis, and five had both. No opening click was recorded in any patient; however, a loud aortic or mitral closing click was recorded in all 43 patients. In patients with St. Jude mitral valve prosthesis, an echo-free space separated the two leaflets during diastole; seven of these also had a mid-diastolic closing and late diastolic reopening motion; two of the seven had an associated closing mid-diastolic click. A mid-diastolic rumble was recorded in six of 28 patients with St. Jude mitral valve prosthesis. In patients with a St. Jude aortic valve prosthesis, left atrium leaflet motion was recorded in 17 of 20 patients and was indistinguishable in appearance from echocardiograms obtained with various eccentric monocusp valves. In addition, we report one case of malfunction of a St. Jude mitral valve and one case of a paravalvular leak diagnosed by echophonocardiography. We concluded that the St. Jude cardiac prosthesis has variable normal phonocardiographic-echocardiographic patterns. Knowledge of these variable patterns is important in assessing patients with suspected malfunction of a St. Jude cardiac prosthesis.
对连续43例植入圣犹达二尖瓣、主动脉瓣或联合瓣膜假体的患者进行了同时心音图和超声心动图研究。28例患者植入二尖瓣假体，20例植入主动脉瓣假体，5例同时植入两种假体。所有患者均未记录到开瓣音；然而，43例患者均记录到响亮的主动脉瓣或二尖瓣关闭喀喇音。在植入圣犹达二尖瓣假体的患者中，舒张期两个瓣叶之间有一无回声间隙；其中7例还有舒张中期关闭和舒张晚期重新开放运动；7例中有2例伴有舒张中期关闭喀喇音。28例植入圣犹达二尖瓣假体的患者中有6例记录到舒张中期隆隆样杂音。在植入圣犹达主动脉瓣假体的患者中，20例中有17例记录到左心房瓣叶运动，其外观与使用各种偏心单叶瓣膜获得的超声心动图无法区分。此外，我们报告了1例圣犹达二尖瓣功能障碍病例和1例经心音超声心动图诊断的瓣周漏病例。我们得出结论，圣犹达心脏假体具有可变的正常心音图-超声心动图模式。了解这些可变模式对于评估疑似圣犹达心脏假体功能障碍的患者很重要。
