经食管超声心动图在小儿二尖瓣双孔成形术中的应用价值

目的:评价术中经食管超声心动图(transesophageal echocardiography,TEE)在小儿二尖瓣关闭不全瓣膜双孔成形术中的作用? 方法:2006年2月~2009年7月共进行22例二尖瓣双孔成形术,术前所有患儿均行常规经胸超声心动图(transthoracic echocardiography,TTE)检查,术中TEE全程监测整个手术过程,开胸前观察二尖瓣及其附属结构的形态?功能及反流程度;瓣膜成形完毕,心脏复跳后,再次观察成形瓣膜及其附属结构的形态?功能及反流情况?结果:本组22例患者中,21例1次性手术成功,1例术中监测发现中量以上反流后,再次行成形术,最终获成功?所有患儿双孔成形瓣膜活动良好,无瓣口狭窄,跨瓣压差均≤5 mmHg,瓣膜反流均在少量以下?结论:术中TEE的应用在小儿二尖瓣双孔成形术中具有非常重要的临床价值,有助于提高瓣膜成形术的成功率,减少手术并发症,避免再次手术?

The application of transesophageal echocardiography in mitral double-orifice valve repair

Objective:To discuss the application value of transesophageal echocardiography(TEE) in double-orifice technique for mitral valve insufficiency in children. Methods:From February 2006 to July 2009,22 patients underwent mitral valve repair using the double-orifice technique. All patients were examined by transthoracic echocardiography (TTE) preoperatively. During the whole procedure,the morphology,function,regurgitation of mitral valve and its affiliated structure were monitored continuously with TEE. The condition of valve was assessed with TEE again postoperatively. Results:In all cases,21 had a successful operation,and one had a second operation for severe regurgitation. All patients showed stable valve function,there were no stenosis of valve,no trans-valve pressure difference and no severe regurgitation. Conclusion:It was of very important clinical value to applicate TEE in double-orifice technique for mitral valve insufficiency in children,which was useful to improve the successful rate and reduce the complications,avoiding once more surgery.