超声心动图对复杂紫绀先心病行牛颈静脉带瓣管道重建右心室流出道的结构及血流动力学评价

目的应用彩色多普勒超声心动图（UCG）观察复杂紫绀先心病行牛颈静脉带瓣管道重建右心室流出道的结构及血流动力学变化。方法应用UCG观察牛颈静脉带瓣管道（BJVC）重建右心室流出道结构及血流动力学在术后7天、1年的变化，对18例患者行右心室（RV）与主肺动脉（MPA）连接状况，测定重建后右心室流出道（RVOT）各截面的直径，右室、肺动脉吻合口的宽度、压差、速度；评价牛颈静脉带瓣管道生物材料有无变性、退行性变及通畅情况；以及自身RVOT、MPA闭合情况。结果术后7天，18例UCG检查肺动脉瓣开放、关闭良好；重建术后1年，18例患者均存活，BJVC瓣膜仍无病理性返流，跨瓣压差小，管道通畅，未见明显血栓形成。结论超声心动图在复杂紫绀先心病行牛颈静脉带瓣管道重建右心室流出道的结构及血流动力学变化中起着非常重要的作用。

Structural and hemodynamic study of right ventricular outflow tract reconstruction with valved bovine jugular vein conduit in cyanotic congenital heart disease by color Doppler echocardiography

Objective To observe structural and hemodynamic changes of right ventricular outflow tract (RVOT) reconstruction with valved bovine jugular vein conduit (BJVC) in cyanotic congenital heart disease by color Doppler echocardiography. Methods Eighteen patients with cyanotic congenital heart disease underwent UCG to observe structure and hemodynamics of RVOT reconstruction with valved BJVC after 7 days and 1 year, including the connective condition of RV and MPA, the various sections diameter of RVOT after operation, the width, blood velocity and pressure gradient of BJVC. Results All of 18 patients survived. Seven days after reconstruction, UCG found no regurgitation of BJVC valve; 1 year later, no regurgitation of pulmonary artery valve by UCG. BJVC valves opened and closed well. BJVCs were unobstructed, in which no obvious thrombi were found. Conclusion Color Doppler echocardiography is very important in structural and hemodynamic study of RVOT reconstruction with valved BJVC in cyanotic congenital heart disease.