经食管超声心动图评价人工心脏瓣膜的功能

本文利用经胸及经食管超声技术观察了51例人工瓣膜置换术后的瓣膜功能及反流程度,并比较了两种技术在评价人工瓣膜中的优缺点。结果表明:(1)经食管超声心动图(TEE)在观察左房及左心耳血栓,判定二尖瓣位人工机械瓣反流程度及鉴别反流与瓣周漏方面均优于经胸超声心动图(TTE)技术,(2)TEE在检出人工二尖瓣反流方面明显优于TTE,且TEE及TTE对人工二尖瓣反流的检出率分别为87.76%和14.29%,(3)TEE在检出主动瓣反流方面与TTE比较,无显著性差异(P>0.05),但可低估瓣膜反流程度。经食管超声技术是判定二尖瓣位人工瓣功能异常的敏感、可靠方法。

TRANSOESOPHAGEAL ECHOCADIOGRAPHY ASSESSMENT OF PROSTHETIC CARDIAC VALVE FUNCTION

Fifty-one patients with prosthetic valve replacement were studied consecutively by transthoracic and transoesophageal echocardiography. The results showed that; (1) transoesophageal echocardiography was consistently better than the transthoracic technique in identifying left atrial or left atrial appendage thrombus and differentiating transvalvular regurgitation from paravalvular leakage in the mitral position; (2) transoesophagcal echocardiography was better than the transthoracic technique in the detection and quantification of prosthetic mitral regurgitation. Transoesophageal echocardiography detected mitral regurgitation in 87.76% of patients with prosthetic mitral valves compared to only 14.29% by transthoracic examination; (3) the detection and quantification of aortic regurgitation were not improved by the transoesophageal technique. The degree of regurgitation in patients with moderate aortic regurgitation was significantly underestimated by the transoesophageal than by the transthoracic technique.It is concluded that transoesophageal echocardiography is a sensitive and reliable method for idontifying prosthetic mitral valve dysfunction.