经食管超声心动图在经导管二尖瓣缘对缘修复治疗二尖瓣反流中的初步应用  

Preliminary evaluation of transesophageal echocardiography in percutaneous edge-to-edge repair of mitral regurgitation

作　　者：蒲朝霞[1] 余蕾[1] 游向东[1] 刘先宝[1] 王建安[1] 何伟[1] 黄品同[2] 

机构地区：[1]浙江大学医学院附属第二医院心脏中心,杭州310009 [2]浙江大学医学院附属第二医院超声科,杭州310009

出　　处：《中华超声影像学杂志》2014年第10期842-846,共5页Chinese Journal of Ultrasonography

摘　　要：目的 初步探讨经食管超声心动图在经导管二尖瓣缘对缘修复治疗二尖瓣反流中的引导、监测价值.方法 10例外科手术高危的中重度（1例）或重度（9例）中心性二尖瓣反流患者,在经食管超声引导下应用MitraClip系统行二尖瓣缘对缘修复术,MitraClip释放后经食管超声即刻评估手术效果并与术前评估相比较.结果 10例患者手术均获得了理想结果,其中5例患者各植入1枚Clip,另5例患者各植入2枚Clip.经食管超声即刻评估手术效果示6例患者二尖瓣反流量减为轻度,2例减为轻中度,2例减为中度.10例患者均未发生Clip脱落、二尖瓣损伤、心包填塞等并发症.结论 MitraClip术是外科手术高危、中重度及重度二尖瓣反流的安全、有效的治疗方法,经食管超声心动图在手术全程中起着重要的引导、监测及确定作用.Objective To explore the preliminary evaluation of transesophageal echocardiography in percutaneous edge-to-edge repair of mitral regurgitation.Methods Ten consecutive patients were treated with percutaneous edge-to-edge repair of mitral regurgitation using the MitraClip system.All of them had moderate-severe （n =1） or severe （n =9） central MR and high operative risk.MitraClip implantation performed under echocardiographic and fluoroscopic guidance in general anaesthesia.Preoperative and postoperative immediate echocardiographic data were prospectively collected.Results All operations succeed with one MitraClip implanted to 5 patients and two MitraClips implanted to 5 patients.Postoperative immediate echocardiography observed MR reduction,6 cases to mild,2 cases to mild-to-moderate and 2 cases to moderate.No complications occurred in all patients,such as Clip off,pericardial effusion/tamponade,or mitral valve damage.Conclusions Echocardiography guarentees the success of MitraClip based transcatheter mitral valve repair operations with safety and effectiveness.

关 键 词：超声心动图描记术 经食管 二尖瓣闭锁不全 二尖瓣成形术 

分 类 号：R654.2[医药卫生—外科学]