Hill A C, Bansal R C, Razzouk A J, Liu M, Bailey L L, Gundry S R
Department of Surgery, Loma Linda University, California, USA.
Ann Thorac Surg. 1997 Sep;64(3):684-9. doi: 10.1016/s0003-4975(97)00524-9.
There is a paucity of literature regarding iatrogenic aortic valve perforation after cardiac operations performed in the vicinity of the aortic valve. This report describes the echocardiographic recognition of iatrogenic aortic valve perforation.
Among 6 patients who had previously under-gone non-aortic valve cardiac operations, a diagnosis of iatrogenic aortic regurgitation was made by transthoracic two-dimensional echocardiography and Doppler color flow imaging.
The location of the aortic valve leaflet perforation varied and depended on the site of the previous intracardiac lesion repair. Repeat operations in 5 patients confirmed the echocardiographic findings. Aortic valve repair was confirmed in 2 patients by transesophageal echocardiography, whereas aortic valve replacement became necessary in 2 other patients. A fifth patient with acquired cardiomyopathy underwent orthotopic heart transplantation.
A detailed two-dimensional echocardiographic examination, along with color flow imaging, should be done to evaluate iatrogenic aortic valve perforation in patients with a new murmur of aortic regurgitation after cardiac operations in proximity to the aortic valve. Precise preoperative diagnosis of this lesion allows optimal surgical planning and treatment.
关于在主动脉瓣附近进行心脏手术后医源性主动脉瓣穿孔的文献较少。本报告描述了医源性主动脉瓣穿孔的超声心动图识别。
在6例先前接受非主动脉瓣心脏手术的患者中，经胸二维超声心动图和多普勒彩色血流成像诊断为医源性主动脉瓣关闭不全。
主动脉瓣叶穿孔的位置各不相同，取决于先前心内病变修复的部位。5例患者再次手术证实了超声心动图检查结果。经食管超声心动图证实2例患者进行了主动脉瓣修复，而另外2例患者则需要进行主动脉瓣置换。第五例获得性心肌病患者接受了原位心脏移植。
对于在主动脉瓣附近进行心脏手术后出现新的主动脉瓣反流杂音的患者，应进行详细的二维超声心动图检查及彩色血流成像，以评估医源性主动脉瓣穿孔。对该病变进行精确的术前诊断有助于制定最佳的手术计划和治疗方案。
