Dávila-Román V G, Westerhausen D, Hopkins W E, Sicard G A, Barzilai B
Division of Cardiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Ann Vasc Surg. 1995 May;9(3):252-60. doi: 10.1007/BF02135284.
The purpose of this study was to determine the impact of transesophageal echocardiography (TEE) on the management of patients with peripheral vascular emboli. We prospectively evaluated the role of TEE in 15 patients with documented peripheral emboli and no evidence of occlusive peripheral vascular disease. The patients were divided in two groups for analysis: group 1 (n = 8) had no clinical evidence of heart disease and group 2 (n = 7) had clinically significant heart disease. TEE provided information regarding the source of embolism in four (50%) patients in group 1, and these findings significantly affected the management of all. Three patients underwent thoracic surgery to remove the source of embolism (aortic valve mass in one and a thrombus in the descending thoracic aorta in two); the other patients was treated with thrombolytic agents. TEE findings had high diagnostic value in all patients in group 2, but the results had a possible effect on clinical management in only two of these patients. TEE provides diagnostic information in most patients with peripheral vascular emboli and this information has a significant influence on management, particularly in those without clinically evident heart disease. TEE should be performed in all patients with documented peripheral embolism.
本研究的目的是确定经食管超声心动图（TEE）对外周血管栓塞患者治疗的影响。我们前瞻性地评估了TEE在15例有外周栓塞记录且无外周血管闭塞性疾病证据的患者中的作用。患者被分为两组进行分析：第1组（n = 8）无心脏病临床证据，第2组（n = 7）有临床显著意义的心脏病。TEE为第1组中的4例（50%）患者提供了有关栓塞来源的信息，这些发现显著影响了所有患者的治疗。3例患者接受了开胸手术以去除栓塞源（1例为主动脉瓣肿物，2例为降主动脉血栓）；另1例患者接受了溶栓治疗。TEE结果在第2组所有患者中具有较高的诊断价值，但仅对其中2例患者的临床治疗可能产生影响。TEE为大多数外周血管栓塞患者提供诊断信息，且该信息对治疗有显著影响，尤其是在无心脏病临床证据的患者中。所有有外周栓塞记录的患者均应进行TEE检查。
