Roberts J W, Lima J A
Transesophageal Echocardiography Laboratory, Johns Hopkins Hospital, Baltimore, Maryland 21205.
Cathet Cardiovasc Diagn. 1994;Suppl 2:69-75.
There are well-defined roles for echocardiography in the evaluation of patients with mitral stenosis who undergo percutaneous transvenous mitral commissurotomy. Transthoracic echocardiography is used to assess mitral valve morphology with particular attention to commissural fusion and valve leaflet calcification, the two most important determinants of the severity of mitral stenosis. This assessment has proven to be useful in patient selection, as immediate and long-term outcome can be predicted from echocardiographic grading scores. The degree of mitral regurgitation can also be assessed and has an influence on outcome. The newer technique of transesophageal echocardiography aids in the detection of left atrial thrombi and may be useful in guiding transseptal puncture and in predicting clinical outcomes. Future applications in this ever-expanding field may ultimately include the use of dobutamine stress echocardiography and intravascular ultrasound catheters. It would appear that balloon valvuloplasty and echocardiography are inexorably linked.
在接受经皮经静脉二尖瓣交界切开术的二尖瓣狭窄患者评估中，超声心动图有着明确的作用。经胸超声心动图用于评估二尖瓣形态，尤其要关注瓣叶融合和瓣膜钙化，这是二尖瓣狭窄严重程度的两个最重要决定因素。这种评估已被证明在患者选择中很有用，因为可以根据超声心动图分级分数预测近期和远期结果。二尖瓣反流程度也可评估，且对结果有影响。较新的经食管超声心动图技术有助于检测左心房血栓，可能有助于指导经房间隔穿刺和预测临床结果。在这个不断扩展的领域中的未来应用最终可能包括使用多巴酚丁胺负荷超声心动图和血管内超声导管。看来球囊瓣膜成形术和超声心动图有着不可分割的联系。
