经食管超声心动图术中评价PV-4人工腱索植入二尖瓣成形术  

Intraoperative Assessment of Mitral Valvuloplasty with PV-4 Artificial Chordae Using Tranesophageal Echocardiography

作　　者：潘文明[1] 舒先红[1] 王琴[2] 洪涛[1] 王春生[1] 孔德红[1] 潘翠珍[1] 

机构地区：[1]复旦大学附属中山医院超声心动图室上海市心血管病研究所,上海市200032 [2]江苏省江阴市中医院

出　　处：《中国超声医学杂志》2007年第9期684-686,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用经食管超声心动图(TEE),评价二尖瓣腱索断裂,行PV-4人工腱索植入二尖瓣成形术效果和应用前景。方法随机对30例二尖瓣腱索断裂患者行二尖瓣成形术,术前及术后即刻进行TEE彩色血流显像检查,其中I组15例患者行人工腱索植入22根(前叶18根,后叶4根)。组15例患者未行人工腱索植入。结果术前I组中度二尖瓣反流为7例(占46.7%),重度二尖瓣反流为8例(占53.3%),II组中度二尖瓣反流为5例(占33.3%),重度二尖瓣反流为10例(占66.7%),术后I组无二尖瓣反流为5例(占33.3%),轻微二尖瓣反流为10例(占66.7%),II组轻微二尖瓣反流为5例(占33.3%),轻度二尖瓣反流为9例(占60.0%),中度二尖瓣反流为1例(占6.7%)。结论TEE彩色血流显像显示植入人工腱索的患者,无二尖瓣反流者占33.3%,轻微反流者占66.7%,而未植入人工腱索的患者均有二尖瓣反流,轻微反流者占33.3%,轻度反流者占60.0%,中度反流者占6.7%,成形效果较人工腱索植入者为差。Objective To evaluate the clinical results and applied value of PV-4 artificial chordae in mitral valvuloplasty using tranesophageal echocardiography（TEE）intraoperatively.Methods Thirty patients with mitral chordae rupture treated with mitral valvuloplasty were randomly underwent TEE pre-and post-operation.Fifteen patients in group Ⅰ were repaired with 22 PV-4 artificial chordaes（18 in anterior and 4 in posterior）and 15 patients in group Ⅱ were repaired without artificial chordae.Results Preoperative diagnosis in group Ⅰ included moderate mitral regurgitation in 7 patients（46.7%）and severe mitral regurgitation in 8（53.3%）;in group Ⅱ included moderate mitral regurgitation in 5（33%）and severe mitral regurgitalion in 10（67%）.Postoperative diagnosis in group Ⅰ included no evidence of mitral regurgitation in 5 patients（33%）and mild mitral regurgitation in 10（67%）,and in group Ⅱ included mild mitral regurgitation in 5（33%）,moderate mitral regurgitation in 9（60%）and severe mitral regurgitation in 1（6.7%）.Conclusions The results of TEE examination demonstrated that the effect of mitral valvuloplasty without PV-4 artificial chordae was worse than that with artificial chordae.

关 键 词：超声心动描记术 经食管 人工腱索 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.2[医药卫生—诊断学]