左室假腱索超声心动图诊断与心脏杂音关系的探讨

本文报告了1983例受检者中应用M型和二维超声心动图(2DE)检出左室假腱索(LVFT)204例(10.28％),并进行分析,以探讨LVFT的超声心动图诊断、鉴别诊断以及假腱索与心脏杂音和心律失常的关系。     

左室假腱索与临床症状的相关性

目的 探讨健康体检者与临床患者左室假腱索检出率的差别及左室假腱索与临床症状相关性.方法 应用彩色多普勒超声仪,对3642例心脏彩超受检者进行多切面、多角度检查,记录与左室假腱索有关的数据,并进行统计学分析.结果 所选3642例心脏彩超受检者,左室假腱索检出率21.25％.健康体检组与临床患者组比较,左室假腱索检出率差异有统计学意义（P＜0.01）.临床症状与假腱索附着的位置、数量、形态有关.左室假腱索的存在可能引起心脏杂音、室性期前收缩、胸闷、气短、胸痛.结论 左室假腱索与临床患者的某些临床症状相关联,在临床上具有一定的指导意义.     

183例左心室假腱索的临床分析

目的讨论左心室假腱索的临床意义。方法应用超声仪常规采用胸骨左缘长轴各切面、心尖和剑下四腔切面观察。结果健康成人组发现左室假腱索110例,占37.2%;患者组发现左室假腱索73例,占39.5%。两组之间统计学检验无显著差异性(χ2=0.2549,P>0.05)。结论左心室假腱索是一种心内正常结构的变异,临床症状明显、有顽固性频发室性早搏,对心功能有一定影响。     

超声心动图对二尖瓣腱索断裂的诊断价值及意义

目的：探讨二尖瓣腱索断裂的彩超特征及临床意义。方法：对彩色多普勒超声心动图诊断的15例二尖瓣腱索断裂患者超声资料、病因进行分析。结果：①二尖瓣腱索断裂超声显示前后叶断裂比例没有明显差异。②二尖瓣腱索断裂病因多样，13例有心脏病基础，见于冠心病、风心病、感染性内膜炎、高血压、肥厚型心肌病等患者。结论：二尖瓣腱索断裂有心脏病基础，彩超不但可以明确心脏病的性质，腱索断裂的部位、程度，也可以判断反流方向和程度，具有其他检查方法不可比拟的优越性。     

大学生左心室假腱索29例分析

目的探讨大学生左心室假腱索检出率及临床意义,为早期防治心脏疾病提供科学依据.方法心脏听诊受检者29158名,检出心脏≥Ⅲ 级收缩期杂音73例,并以73例杂音做为基本入选条件,应用心脏B超及彩色多普勒显像对73例心脏杂音进行检查.结果检出左心室假腱索29例.左心室假腱索人群检出率为0.99‰,心脏杂音假腱索检出率为39.73%,男女检出率无统计学意义(P＞0.25).结论心脏杂音左心室假腱索检出率较高;左心室假腱索与心脏生理性杂音有关,应与器质性心脏疾病鉴别;与其他心脏疾病的关系有待于进一步探讨.     

左室假腱索致室性期前收缩96例观察

左心室假腱索(LVPT)引起的室性心律失常如室性期前收缩、室性心动过速等在临床中常可见到,但国内外对此类患者的长期预后报道很少。我科对1996～2005年间96例超声诊断的LVPT所致室性期前收缩患者进行了随访,现将观察结果报道如下:1对象与方法1.1一般资料本组96例,男65例,女31例,年龄15～45岁,平均(30.5±4.6)岁,多因室性期前收缩在我科门诊或住院诊断。1.2检查与随访全部病例均详细采集病史(包括家族史)、体格检查、X线胸片、常规心电图及24h动态心电图、心脏彩超等检查。年龄40岁以上者行活动平板运动试验和心脏核素心肌灌注显像(ECT)…     

应用彩色多普勒检查左室假腱索的临床意义

随着心脏彩色普勒超声诊断仪的发展和操作技术的不断提高,左室假腱索检出越来越多.我们通过地2000年以来检查出的112例有左室假腱索患者进行回顾分析如下.     

左室假腱索与功能性房性心律失常2例

例 1,男 ,8岁 ,因胸闷、气短、乏力 5d入院。查体 :体温37.6℃ ,神清 ,呼吸平稳 ,咽充血 ,扁桃体I度肿大。心前区无隆起 ,心界不大 ,心音有力 ,心率 10 2次 /min ,心律不齐 ,可闻及频发期前收缩 ,无杂音。双肺听诊正常 ,腹平软。血WBC 7.4× 10 9/L ,N 0 .34,L 0 .6 3,ECG示频发性房性期前收缩 ,二联律。心肌酶谱正常 ,心脏彩色多普勒B超检查示 :心脏各房室腔大小及大血管内径测值正常 ,房室间隔回声连续完整 ,各瓣膜无增厚 ,启闭良好 ,左室内见长约 2 5mm条状回声光带连与室间隔。诊断为左心室假腱索 ,房性期前收缩 ,上呼吸道感染。予…     

改良腱索转移法治疗二尖瓣前叶脱垂(附16例临床分析)

Objective To introduce an operative technique for prolapse of the anterior leaflet of mitral valve. Methods From January 2002 through May 2005, chordal transfer and "edge-to-edge" technique was performed in 16 cases with serious mitral valve re- gurgitation due to prolapse of the anterior leaflet. The etiology was chordal rupture in 12 cases and chordtal elongation in 4. The mean regurgitation area yam (14.76±3.28) cn2. Left ventricular ejection fraction (LVEF) was 33% - 69% before operation. Among those patients, 5 were in NYHA function class Ⅲ and 11 in class Ⅳ. Operations were performed under general anesthesia and car- diopulmonary bypass. First, "edge to edge" technique was performed. The free edge of the prolapsed anterior leaflet was sutyred to corresponding posterior leaflet. Then quadrangular resection was performed to transfer segment of posterior leaflet with its attached chordae. At last, the posterior leaflet was approximated after quadrangular resetion. Echocardiography was performed in each patient before discharge and at the times of follow-up. Results All patients survived the operation. One patient nequired mitral valve re- placement due to anterior leaflet perforation 3 days after the operatiom. The rest were free from reoperation. At the time d follow-up, all these patients were in NYHA functional class Ⅰ. Echocardiography showed neither stenosis nor significant regurgitation of the mitral valve. The cross-sectional area of the mitral valve was 3.3 -4.8 cm2[mean(3.78±0.52)cm2]. The mean regurgitation area was (0.45±0.22) cm2. Both dimension of left atrium and left vantricule reduced significantly. The diameter of left atrium was (48.26± 11.12) mm pre-operation vs. (37.57±9.56) mm post-operation (P=0.028). The ead-diastolic diameter of the left ventricule was (61.43±8.24)mm pre-operation vs (42.35±10.79) mm post-operation (P = 0.008). Conctusion Chordal transfer and "edge- to-edge" technique provides good results for repair of anterior leaflet prolapse of mitral valve.