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[二尖瓣狭窄的术前和术后超声心动图评估]

[Pre- and post-operative echocardiographic evaluations of mitral stenosis].

作者信息

Pezzano A, Ciliberto G R, Gronda E, Bossi M

出版信息

G Ital Cardiol. 1977;7(6):575-83.

PMID:892275
Abstract

46 patients, affected by pure mitral stenosis, underwent echocardiographic study before and after mitral commissurotomy. The following echocardiographic parametres were considered: 1) closing velocity of anterior mitral leaflet (E-F slope); 2) amplitude of the mitral valve motion; 3) intensity and number of echoes coming from the mitral leaflet; 4) posterior leaflet motion; 5) left atrial diameter index; 6) right ventricolar diameter index; 7) left atrial and aorta diameter ratio. Moreover mitral diameter, mitral fibrosis or calcification, and possible mitral incontinence were evaluated intraoperatively before and after commissurotomy. The pre-operative echocardiographic examination of the mitral stenosis showed the following specific aspects: 1) reduced E-F slope, significantly correlated with the severity of the stenosis; 2) abnormally moving posterior mitral leaflet; 3) enlargement of the left atrium, directly correlated with the degree of the mitral stenosis. Correspondence was noted between the echocardiographic and the intraoperative evaluation of the anathomical pattern of mitral valve. Postoperatively the echocardiograms showed: 1) improved E-F slope, directly correlated with the surgical dilatation of the valve; 2) persistent abnormal movement of the posterior mitral leaflet; 3) disappeared correlation between the surgical diameter of mitral valve and the left atrial index. The ECHO proved to be a good diagnostic method for both a qualitative and a semiquantitative evaluation of mitral stenosis. The ECHO is also quite usefull in evaluating modifications induced by commissurotomy.

摘要

46例单纯二尖瓣狭窄患者在二尖瓣交界切开术前和术后接受了超声心动图检查。考虑了以下超声心动图参数:1)二尖瓣前叶关闭速度(E-F斜率);2)二尖瓣活动幅度;3)来自二尖瓣叶的回声强度和数量;4)后叶活动;5)左心房直径指数;6)右心室直径指数;7)左心房与主动脉直径比。此外,在交界切开术前和术后术中评估二尖瓣直径、二尖瓣纤维化或钙化以及可能的二尖瓣反流情况。二尖瓣狭窄的术前超声心动图检查显示以下具体情况:1)E-F斜率降低,与狭窄严重程度显著相关;2)二尖瓣后叶活动异常;3)左心房扩大,与二尖瓣狭窄程度直接相关。二尖瓣解剖结构的超声心动图评估与术中评估之间存在对应关系。术后超声心动图显示:1)E-F斜率改善,与瓣膜手术扩张直接相关;2)二尖瓣后叶持续异常活动;3)二尖瓣手术直径与左心房指数之间的相关性消失。超声心动图被证明是二尖瓣狭窄定性和半定量评估的良好诊断方法。超声心动图在评估交界切开术引起的改变方面也非常有用。

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