经食管超声心动图术中评价PV-4人工腱索植入二尖瓣成形术

目的应用经食管超声心动图（TEE）,评价二尖瓣腱索断裂,行PV-4人工腱索植入二尖瓣成形术效果和应用前景。方法随机对30例二尖瓣腱索断裂患者行二尖瓣成形术,术前及术后即刻进行TEE彩色血流显像检查,其中Ⅰ组15例患者行人工腱索植入22根（前叶18根,后叶4根）。Ⅱ组15例患者未行人工腱索植入。结果术前Ⅰ组中度二尖瓣反流为7例（占46.7%）,重度二尖瓣反流为8例（占53.3%）,Ⅱ组中度二尖瓣反流为5例（占33.3%）,重度二尖瓣反流为10例（占66.7%）,术后Ⅰ组无二尖瓣反流为5例（占33.3%）,轻微二尖瓣反流为10例（占66.7%）,Ⅱ组轻微二尖瓣反流为5例（占33.3%）,轻度二尖瓣反流为9例（占60.0%）,中度二尖瓣反流为1例（占6.7%）。结论TEE彩色血流显像显示植入人工腱索的患者,无二尖瓣反流者占33.3%,轻微反流者占66.7%,而未植入人工腱索的患者均有二尖瓣反流,轻微反流者占33.3%,轻度反流者占60.0%,中度反流者占6.7%,成形效果较人工腱索植入者为差。

Intraoperative Assessment of Mitral Valvuloplasty with PV-4 Artificial Chordae Using Tranesophageal Echocardiography

Objective To evaluate the clinical results and applied value of PV-4 artificial chordae in mitral valvuloplasty using tranesophageal echocardiography(TEE)intraoperatively.Methods Thirty patients with mitral chordae rupture treated with mitral valvuloplasty were randomly underwent TEE pre-and post-operation.Fifteen patients in group I were repaired with 22 PV-4 artificial chordaes(18 in anterior and 4 in posterior)and 15 patients in group II were repaired without artificial chordae.Results Preoperative diagnosis in group I included moderate mitral regurgitation in 7 patients(46.7%)and severe mitral regurgitation in 8(53.3%);in group II included moderate mitral regurgitation in 5(33%)and severe mitral regurgitalion in 10(67%).Postoperative diagnosis in group I included no evidence of mitral regurgitation in 5 patients(33%)and mild mitral regurgitation in 10(67%),and in group II included mild mitral regurgitation in 5(33%),moderate mitral regurgitation in 9(60%)and severe mitral regurgitation in 1(6.7%).Conclusions The results of TEE examination demonstrated that the effect of mitral valvuloplasty without PV-4 artificial chordae was worse than that with artificial chordae.