多普勒彩色超声心动图对肺动脉闭锁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研究探讨--附4例报道

目的 多普勒彩色超声心动图对肺动脉闭锁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研究。方法 应用多普勒彩色超声心动图观察4例紫绀型先心病肺动脉闭锁行牛颈静脉带瓣管道重建右室流出道（RVOT）后的结构及血流动力学变化，术后7d、1年观察右心室（RV）与肺动脉（MPA）连接状况，测定重建后右室流出道各截面的直径，右室、肺动脉吻合口的宽度、血流速度和压差，从而评价牛颈静脉带瓣管道通畅情况。结果 重建术后1年，4住患者均存活，多普勒彩色超声心动图于术后7d、1年检查示肺动脉瓣膜关闭良好，无明显返流，跨瓣压差小；全部带瓣管道通畅，未见明显血栓形成。结论 多普勒彩色超声心动图在复杂先心病肺动脉闭锁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 pulmonary atresia by color Doppler echocardiography

Objective] To observe structural and hemodynamic changes of right ventricular outflow tract reconstruction with valved bovine jugular vein conduit in pulmonary atresia by color Doppler echocardiography. Methods] Use color Doppler echocardiography to observe structural and hemodynamic changes of right ventricular outflow tract reconstruction with valved bovine jugular vein conduit in 4 pulmonary atresia patients after 7 days,one year, observe connection of RV and MPA, measure diameter of reconstructured RVOT, right ventricle, the width of pulmonary artery, the speed and pressure gradient of blood flow in valved bovine jugular vein conduit. Results] After the reconstruction, all patients survive one year later. After 7 days and one year, color Doppler echocardiography showed pulmonary valves open and close well without obvious regurgitation, the pressure gradient was low; valved bovine jugular vein conduit unobstructed completely and no obvious thrombus. Conclusions] Color Doppler echocardiography is very important in structural and hemodynamic research of right ventricular outflow tract reconstruction with valved bovine jugular vein conduit in pulmonary atresia.