经食管超声心动图在经导管主动脉瓣置入术中的应用价值  

Application Value of Transesophageal Echocardiography in Transcatheter Aortic Valve Implantation

作　　者：钟晓娇 周翠翠[1] 黄智华[1] 黄志平[1] ZHONG Xiaojiao;ZHOU Cuicui;HUANG Zhihua;HUANG Zhiping(Department of Ultrasound,Ganzhou People's Hospital,Ganzhou 341099,Jiangxi,China)

机构地区：[1]赣州市人民医院超声科,江西赣州341099

出　　处：《医学信息》2024年第19期148-151,共4页Journal of Medical Information

摘　　要：目的 研究经食管超声心动图(TEE)在经导管主动脉瓣置入术(TAVI)中的应用价值。方法 以2019年1月-2023年8月赣州市人民医院拟行TAVI治疗的20例患者为研究对象,均给予围术期经食管超声心动图(TEE)与多层螺旋CT(MSCT)检查,比较TEE与MSCT的术前主动脉瓣环检测结果(瓣环内径、瓣环面积),分析其相关性,并对比术后人工主动脉瓣与术前主动脉瓣的TEE参数(最大流速、最大跨瓣压差、平均跨瓣压差),统计患者的术后TEE特征及并发症情况。结果 TEE与MSCT的主动脉瓣环检测结果(瓣环内径、瓣环面积)比较,差异无统计学意义(P>0.05)。经Spearman分析显示,TEE与MSCT的检测结果(瓣环内径、瓣环面积)具有强相关性(P<0.05)。患者术后人工主动脉瓣最大流速、最大跨瓣压差、平均跨瓣压差均小于术前主动脉瓣(P<0.05)。经TAVI治疗后,患者人工主动脉瓣环均呈椭圆形,瓣膜启闭良好。术后,共出现1例瓣周漏(7.14%)、1例瓣膜反流(7.14%),无冠状动脉阻塞、传导阻滞、心脏压塞等并发症情况。结论 TEE可准确反映TAVI患者的主动脉瓣参数,具有良好的围术期监测作用。Objective To study the application value of transesophageal echocardiography(TEE)in transcatheter aortic valve implantation(TAVI).Methods A total of 20 patients who underwent TAVI in Ganzhou People's Hospital from January 2019 to August 2023 were selected as the research objects.Perioperative transesophageal echocardiography(TEE)and multi-slice spiral CT(MSCT)were performed.The preoperative aortic annulus detection results(annulus diameter and annulus area)of TEE and MSCT were compared,and their correlation was analyzed.The TEE parameters(maximum flow rate,maximum transvalvular pressure difference and average transvalvular pressure difference)of postoperative artificial aortic valve and preoperative aortic valve were compared.The postoperative TEE characteristics and complications of patients were statistically analyzed.Results There was no significant difference in aortic annulus detection results(annulus diameter,annulus area)between TEE and MSCT(P>0.05).Spearman analysis showed that there was a strong correlation between TEE and MSCT detection results(annulus diameter,annulus area)(P<0.05).The maximum flow velocity,maximum transvalvular pressure difference and average transvalvular pressure difference of the artificial aortic valve were lower than those of the preoperative aortic valve(P<0.05).After TAVI treatment,the artificial aortic annulus of the patients was oval,and the valve was open and closed well.After operation,there were 1 case of perivalvular leakage(7.14%)and 1 case of valvular regurgitation(7.14%).There were no complications such as coronary artery occlusion,conduction block and cardiac tamponade.Conclusion TEE can accurately reflect the aortic valve parameters of TAVI patients and has a good perioperative monitoring effect.

关 键 词：经导管主动脉瓣置入术 经食管超声心动图 主动脉瓣狭窄 人工主动脉瓣环 瓣周漏 

分 类 号：R445.1[医药卫生—影像医学与核医学]