Ishizuka N, Sakai K, Nakagawa M, Niki K, Fujita Y, Tanimoto K, Nakamura K, Hosoda S, Hashimoto A, Koyanagi H
Department of Cardiology, Tokyo Women's Medical College.
J Cardiol. 1995 Mar;25(3):139-46.
Leakage from the composite graft at the site of coronary anastomosis into the perigraftal space (pseudoaneurysm) is an important complication of Bentall's operation. The clinical value of transesophageal echocardiography (TEE) for detecting this graft failure was evaluated in 30 patients who underwent Bentall's operation or Piehler's modification. Three patients (10%) had perigraftal leakage (pseudoaneurysm). TEE demonstrated the leakage site which was not clearly showed by computed tomography (CT) scan and aortography. The detection rate of the anastomosed native coronary artery was 89% (left: 100%, right: 67%). Interposition graft by Pichler's modification method was detected in 96% (left: 100%, right: 92%) of cases by TEE, but only in 43% (left: 57%, right: 29%) by CT scan (left: p < 0.005, right: p < 0.0001). The detection rate of the right coronary artery, interposition graft to right coronary artery, and their color signals were lower than those of the left coronary artery. TEE has considerable diagnostic value in evaluating patients after Bentall's operation.
复合移植物在冠状动脉吻合部位漏入移植物周围间隙（假性动脉瘤）是Bentall手术的重要并发症。对30例行Bentall手术或Piehler改良术的患者评估经食管超声心动图（TEE）检测这种移植物失败的临床价值。3例患者（10%）发生移植物周围渗漏（假性动脉瘤）。TEE显示了渗漏部位，而计算机断层扫描（CT）和主动脉造影未清晰显示该部位。吻合的自身冠状动脉的检出率为89%（左冠状动脉：100%，右冠状动脉：67%）。通过TEE，采用Pichler改良法的间置移植物在96%的病例中被检测到（左冠状动脉：100%，右冠状动脉：92%），但CT扫描仅在43%的病例中检测到（左冠状动脉：57%，右冠状动脉：29%）（左冠状动脉：p<0.005，右冠状动脉：p<0.0001）。右冠状动脉、右冠状动脉间置移植物及其彩色信号的检出率低于左冠状动脉。TEE在评估Bentall手术后的患者方面具有相当大的诊断价值。
