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[手术瓣膜修复患者的术中经食管超声心动图]

[Intraoperative transesophageal echocardiography in patients with surgical valve repair].

作者信息

Gadeva S, Kratunkov P, Dzhorgova Iu, Nachev G, Chirkov A

出版信息

Khirurgiia (Sofiia). 1995;48(1):59-63.

PMID:7474761
Abstract

For a period of 13 months (from April 1993 till May 1994) 14 patients (5 men and 9 women) have been examined intraoperatively with transesophageal echocardiography. Nine of the patients were with mitral valve lesion, three of them with mitral valve lesion, complicated with tricuspidalisation, one patient with mitral-aortic valve lesion and high grade tricuspid regurgitation and one patient with aortic valve disease. The purpose of the intraoperative transesophageal echocardiography was to surgical valve repair by measuring the residual stenosis and regurgitation. Intraoperative transesophageal echocardiography evaluation was made by biplane two-dimensional echocardiography, colour Doppler mapping and pulse wave Doppler after CPB before sternum closure. In 13 of the examined patients the effect of the surgical valve repair was assessed by transesophageal echocardiography as very good. In one of the cases intraoperative transesophageal echocardiography indicated aortic and mitral valve replacement because of high grade aortic and mitral replacement, persisting after surgical valve repair of both valves. Intraoperative transesophageal echocardiographic findings were compared with postoperative transesophageal echocardiography before dehospitalisation of the patients. The results of both echocardiographic examinations, correlate to a great extent. The existing difference in assessment of the degree of valvular lesions is due to the specific intraoperative haemodynamic situation. Intraoperative transesophageal echocardiography is a valuable method in assessment of surgical valve repair.

摘要

在13个月的时间里(从1993年4月至1994年5月),对14例患者(5例男性和9例女性)进行了术中经食管超声心动图检查。其中9例患者患有二尖瓣病变,3例合并二尖瓣病变并伴有三尖瓣化,1例患有二尖瓣 - 主动脉瓣病变及重度三尖瓣反流,1例患有主动脉瓣疾病。术中经食管超声心动图的目的是通过测量残余狭窄和反流来评估手术瓣膜修复情况。在体外循环后胸骨闭合前,通过双平面二维超声心动图、彩色多普勒成像和脉冲波多普勒对术中经食管超声心动图进行评估。在13例受检患者中,经食管超声心动图评估手术瓣膜修复效果非常好。在其中1例病例中,术中经食管超声心动图显示由于主动脉瓣和二尖瓣置换术后仍存在重度反流,尽管对两个瓣膜进行了手术瓣膜修复,仍需进行主动脉瓣和二尖瓣置换。将术中经食管超声心动图检查结果与患者出院前的术后经食管超声心动图检查结果进行比较。两种超声心动图检查结果在很大程度上具有相关性。瓣膜病变程度评估中存在差异是由于术中特定的血流动力学情况所致。术中经食管超声心动图是评估手术瓣膜修复的一种有价值的方法。

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