超声心动图在二尖瓣置换术后远期心功能不全病因诊断中的应用

 目的探索超声心动图在二尖瓣置换(MVR)术后远期心功能不全病因诊断中的作用。方法超声随访44例MVR患者术后3个月～13.5a，并根据手术的远期效果，分为心功能不全组(A组)和康复组(B组)。除注意人工瓣和自然瓣的病变外，还分析了这2组手术前后左房、左室内径及左室射血分数(EF)的差异。结果超声显示A组二尖瓣位单组或伴主动脉瓣位双组人工瓣异常5例，其它自然瓣明显病变11例。术后A组的左室内径明显大于B组(P＜0.05)，EF值明显小于B组(P＜0.01)。超声心动图提供的信息为36.4％心功能不全代偿期和66.7％失代偿期患者诊断出了导致心功能障碍的主要原因。结论MVR手术前后超声检查对术后远期心功能不全的诊断具有实用价值。

Role of echocardiographic in diagnosis of late cardiac insufficiency after mitral valve replacement

Objective To evaluate the role of echocardiography in diagnosis of late cardiac insufficiency (CI) after mitral valve replacement(MVR).Methods Forty four patients with MVR were followed up for 3 months to 13.5 years.All patients were studied with two-dimensional or color Doppler echocardiography before and after the operations.The patients were divided into group B (21 cases) and group A (23 cases) according to the long term effect of the operations.Not only the valve prosthesis and other natural valve were examined,but also the difference among left atrium,left ventricle and ejection fraction before and after MVR were been analyzed for both groups.Results The ultrasonography showed 5 patients with abnormal valve prosthesis and 11 patients with other natural valve diseases in the group A,but 21 cases in group B were recovered better after operation.The mean ventricular bore in group A was larger than that in group B(P<0 05) and EF in group A was less (p<0 01).The main reasons for heart failure in 36 4% (4/11) of patieuts with heart fumction at compensatory phase and in 66 7%(8/12)of patients with decompensation of heart function were found by ultra sonography.Conclusions Color Doppler flow imaging is an effective method for diagnosing late cardiac insufficiency after MVR.It plays an important role in clinical diagnosis of CI.