术中经食管超声在心脏瓣膜置换术后异常情况诊疗中的应用

目的评价术中经食管超声心动图(IOTEE)在心脏瓣膜置换术后异常情况诊疗中的作用。方法回顾性分析45例心脏瓣膜置换术后发生异常情况患者,对IOTEE在诊断及治疗心脏瓣膜置换术后异常情况中的作用进行评估及分析。结果 45例心脏瓣膜置换术后发生异常并发症的患者中,IOTEE检出瓣周漏23例(23/45,51.11%),卡瓣4例(4/45,8.89%),室壁运动异常6例(6/45,13.33%),感染性心内膜炎6例(6/45,13.33%),人工瓣膜狭窄4例(4/45,8.89%),升主动脉与胸骨粘连2例(2/45,4.44%),均经手术证实。结论 IOTEE可检出心脏瓣膜置换术后瓣周漏、人工瓣膜卡瓣、感染性心内膜炎等异常情况,帮助术者正确判断并及时处理。

Clinical application of intraoperative transesophageal echocardiography in unusual complications after cardiac valve replacement

Objective To analyze the value of intraoperative transesophageal echocardiography (IOTEE) in diagnosis and therapy of unusual complications after cardiac valve replacement. Methods A total of 45 patients with complications after cardiac valve replacement were enrolled and the echocardiographic features of unusual complications were retrospectively analyzed with IOTEE. Results In all 45 patients with complications, IOTEE identified 23 patients (23/45, 51.11%) with paravalvular leaks, 4 patients (4/45, 8.89%) with stuck prosthetic valves, 6 patients (6/45, 13.33%) with regional wall motion abnormalities, 6 patients (6/45, 13.33%) with infective endocarditis, 4 patients (8/45, 8.89%) with prosthetic valve stenosis and 2 patients (2/45, 4.44%) with ascending aorta adhesion to the chest bone. All the complications were confirmed by surgery. Conclusion IOTEE can detect unusual complications after cardiac valve replacement, such as paravalvular leaks, stuck prosthetic valves, infective endocarditis and so on, thus contribute to the accurate diagnosis and suitable treatment of postoperative complications.