经食管超声心动图在牛心包主动脉瓣置换术中的应用

发布时间：2018-03-27 16:51

本文选题：主动脉瓣　切入点：外科手术　出处：《中国医学影像技术》2017年03期

【摘要】：目的评价术中经食管超声心动图(IOTEE)在牛心包主动脉瓣置换术中的应用价值。方法回顾性分析拟施行牛心包主动脉瓣置换术的106例患者,分别于体外循环前采用IOTEE测量和术中解剖测量主动脉瓣环径、主动脉窦部和主动脉窦管交界直径、主动脉瓣叶有效高度(eH)。结果术前拟行牛心包主动脉瓣置换术106例患者,其中8例经IOTEE术前补充诊断后修改手术方式被排除。余98例均接受牛心包主动脉瓣置换术。98例IOTEE首要诊断与手术诊断符合率为100%,5例(5/98,5.10%)IOTEE次要诊断与手术诊断不相符。98例患者体外循环前IOTEE提示瓣叶数目与术中探查符合率100%、瓣叶穿孔符合率80.00%,瓣叶赘生物符合率85.71%、老年退行性钙化符合率100%、风湿性病变符合率100%。体外循环前IOTEE测量的主动脉瓣环径、主动脉窦部和主动脉窦管交界直径、eH与术中实际测量结果相关性良好(r均0.8,P均0.05)。结论 IOTEE对于评估牛心包主动脉瓣置换术的可行性、指导选择手术方案和预估手术效果有重要意义。
[Abstract]:Objective to evaluate the value of intraoperative transesophageal echocardiography (IOTEE) in bovine pericardial aortic valve replacement. Methods 106 patients undergoing bovine pericardial aortic valve replacement were retrospectively analyzed. Before cardiopulmonary bypass (CPB), the diameter of aortic annulus, the diameter of aortic sinus and aortic sinus canal, and the effective height of aortic valve were measured by IOTEE and anatomical method respectively. Results Bovine pericardial aortic valve replacement was performed in 106 patients before CPB. Among them, 8 cases were excluded after modified operation by IOTEE before operation. 98 cases underwent bovine pericardial aortic valve replacement. The coincidence rate of primary diagnosis and operation diagnosis of IOTEE was 100%. 5 / 985.10% secondary diagnosis was not consistent with operation diagnosis. Before cardiopulmonary bypass (CPB), IOTEE showed that the number of lobes corresponded with the exploratory rate, the rate of valve perforation was 80.00, the coincidence rate of flap vegetations was 85.71, the coincidence rate of senile degenerative calcification was 100 and the coincidence rate of rheumatic diseases was 100. IOTEE was measured before cardiopulmonary bypass. The diameter of the aortic annulus, The diameter of aortic sinus and aortic sinus junction was correlated well with the actual measurement results during operation. Conclusion IOTEE is feasible for evaluating bovine aortic valve replacement in pericardial aorta, and the correlation between the diameter of aortic sinus and aortic sinus junction is 0. 8% and 0. 05% (P < 0. 05). It is of great significance to guide the selection of surgical plan and estimate the effect of operation.
【作者单位】：武汉亚洲心脏病医院超声中心;
【基金】：武汉市卫生和计划生育委员会项目基金(WX16E32)
【分类号】：R540.45;R654.2

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