Stoddard M F, Longaker R A
Division of Cardiology, University of Louisville, KY 40202.
Am Heart J. 1993 Jun;125(6):1676-81. doi: 10.1016/0002-8703(93)90758-2.
Transthoracic echocardiography has played a useful role in the screening of cardiac transplant donors. However, transthoracic echocardiograms may be suboptimal in many patients on ventilators. The role of transesophageal echocardiography in cardiac donor screening is unknown. Therefore we compared the potential benefit of transesophageal echocardiography combined with transthoracic echocardiography in 24 (16 men and 8 women) consecutive brain-dead patients with a mean age of 29 +/- 9 years (range 16 to 44 years), who were being considered as cardiac transplant donors. Transthoracic echocardiography was performed immediately before or after transesophageal echocardiography. Transthoracic echocardiography was technically difficult in 7 of 24 (29%) patients. Results of transesophageal echocardiography were abnormal in five of the seven patients and demonstrated left (n = 4) and right (n = 3) ventricular wall motion abnormalities and concentric left ventricular hypertrophy (n = 2). The four patients with wall motion abnormalities were eliminated as potential donors. In 16 of 17 patients with technically adequate transthoracic echocardiograms, transesophageal and transthoracic echocardiographic findings agreed and demonstrated normal hearts in 13 patients, left (n = 2) and right (n = 1) ventricular wall motion abnormalities in two patients, and isolated concentric left ventricular hypertrophy in one patient. In 1 of the 17 patients with a technically adequate transthoracic echocardiographic study, a bicuspid aortic valve was demonstrated by transesophageal echocardiography but not diagnosed by transthoracic echocardiography. Overall seven patients were eliminated as cardiac donors on the basis of transesophageal echocardiograms (n = 7), transthoracic echocardiograms (n = 2), or both.(ABSTRACT TRUNCATED AT 250 WORDS)
经胸超声心动图在心脏移植供体筛查中发挥了有益作用。然而，对于许多使用呼吸机的患者，经胸超声心动图检查结果可能并不理想。经食管超声心动图在心脏供体筛查中的作用尚不清楚。因此，我们比较了经食管超声心动图联合经胸超声心动图对24例（16例男性，8例女性）连续脑死亡患者的潜在益处，这些患者平均年龄为29±9岁（16至44岁），正被考虑作为心脏移植供体。经食管超声心动图检查前后立即进行经胸超声心动图检查。24例患者中有7例（29%）经胸超声心动图检查在技术上存在困难。7例患者中5例经食管超声心动图检查结果异常，表现为左心室（n = 4）和右心室（n = 3）壁运动异常以及左心室向心性肥厚（n = 2）。4例壁运动异常的患者被排除作为潜在供体。在17例经胸超声心动图检查技术上足够的患者中，16例经食管和经胸超声心动图检查结果一致，13例患者心脏正常，2例患者存在左心室（n = 2）和右心室（n = 1）壁运动异常，1例患者存在孤立性左心室向心性肥厚。在17例经胸超声心动图检查技术上足够的患者中，1例经食管超声心动图检查发现二叶式主动脉瓣，但经胸超声心动图检查未诊断出来。总体而言，7例患者基于经食管超声心动图检查（n = 7）、经胸超声心动图检查（n = 2）或两者被排除作为心脏供体。（摘要截短至250字）
