超声心动图在心脏人工机械瓣卡瓣诊断中的应用价值  

The Value of Echocardiography in the Diagnosis of Stuck Heart Mechanical Valve Leaflet

作　　者：蒙媛丽 陈曦 刘英梅[1] MENG Yuan-li;CHEN Xi;LIU Ying-mei(Department of Cardiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院心血管内科,510120

出　　处：《岭南急诊医学杂志》2022年第4期338-340,354,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:分析心脏人工机械瓣卡瓣的超声心动图特点,探讨超声心动图在人工机械瓣卡瓣诊断中的应用价值。方法:收集我院2014年5月至2022年1月经手术证实为机械瓣卡瓣的患者,分析其二次换瓣术前超声图像,包括在二维及三维模式下机械瓣形态及活动情况、机械瓣前向血流及反流情况、机械瓣前向血流多普勒频谱,并与首次换瓣术后超声心动图数据比较。结果:20例机械瓣卡瓣患者中,位于二尖瓣、主动脉瓣分别为13例、7例,其中机械瓣单纯血栓形成7例、单纯血管翳形成3例、血管翳并血栓形成10例;人工二尖瓣、主动脉瓣二次换瓣术前前向血流峰值流速、峰值跨瓣压差及肺动脉收缩压均较首次换瓣术后显著增高。结论:超声心动图是快速、有效诊断机械瓣卡瓣的首选无创检查方法。Objective:To analyze the echocardiographic characteristics of stuck heart mechanical valve leaflet and explore the value of echocardiography in the diagnosis of stuck heart mechanical valve leaflet.Methods:Echocardiographic features of consecutive patients with stuck heart mechanical valve proven by second cardiac operation from May2014 to January 2022 were retrospectively collected and analyzed. The aspects were observed as follows:the shape and motion of the mechanical valve by both 2 dimensional and 3 dimensional echocardiography;the forward flow and regurgitation of the mechanical valve;the Doppler spectrum of the mechanical valve.Results:Among the 20 patients,13 had stuck mitral mechanical valve while 7 had stuck aortic mechanical valve. Thrombosis,pannus,and pannus combined with thrombus occurred in 7,3,10 cases,respectively. The maximal velocities,the maximal transvalvular pressure gradient and pulmonary arterial systolic pressure before the second surgery were significantly higher than that after the first valve replacement.Conclusion:Echocardiography is the preferred non-invasive examination method for rapid and effective diagnosis of stuck heart mechanical valve leaflet.

关 键 词：超声心动图 心脏机械瓣 卡瓣 

分 类 号：R540.45[医药卫生—心血管疾病] R542.5[医药卫生—内科学]