先天性主动脉瓣四叶畸形的超声诊断特点及其术后随访结果
发布时间：2018-11-12 15:33
【摘要】：目的探讨超声心动图对先天性主动脉瓣四叶畸形(CQAV)的诊断特点,并总结CQAV的临床和术后随访情况,评价其预后及相关因素。方法采用经胸超声心动图、经食管超声心动图及经胸实时三维超声心动图观察主动脉瓣叶数量、分布形态、回声、启闭及血流动力学情况,并对其中手术患者进行超过1年的随访。结果 69例CQAV患者中,男56例,女13例,年龄2~75岁。57例为经胸超声心动图确诊,12例为经食管超声确诊,其中9例同时行实时三维超声心动图检查。超声心动图显示CQAV患者均有不同程度的主动脉瓣反流,此外,有4例合并主动脉瓣轻度狭窄,9例有明确的节段性室壁运动异常。CQAV主要以单纯畸形为主者60例,占87%,其中24例经手术证实(超声准确率95.8%),17例行病理检查。17例患者行主动脉瓣置换术(机械瓣15例、生物瓣2例),其中2例同时行冠状动脉旁路移植术,2例因合并二尖瓣病变,同时行二尖瓣置换术及三尖瓣成形术。手术病理结果发现:Hurwitz分型为A型8例,占47%,B型7例,占41.1%,C型及F型各1例,占5.9%。超声对CQAV患者术后随访发现,患者的预后与左室内径和EF值密切相关。结论超声心动图能够准确诊断四叶式主动脉瓣畸形及其心内合并症,对选择相应的治疗方案和随访有着非常重要的价值。
[Abstract]:Objective to investigate the characteristics of echocardiography in the diagnosis of congenital aortic four-lobe malformation (CQAV), and to summarize the clinical and postoperative follow-up of CQAV, and to evaluate its prognosis and related factors. Methods Transthoracic echocardiography, transesophageal echocardiography and transthoracic real-time three-dimensional echocardiography were used to observe the number, distribution, echo, opening and closing and hemodynamics of aortic valve. The operative patients were followed up for more than one year. Results among 69 patients with CQAV, 56 were male and 13 were female, the age was 275.57 cases were diagnosed by transthoracic echocardiography, 12 cases were diagnosed by transesophageal echocardiography, 9 cases were examined by real-time three-dimensional echocardiography at the same time. Echocardiography showed that all patients with CQAV had different degree of aortic regurgitation. In addition, there were 4 cases with mild aortic stenosis and 9 cases with definite segmental ventricular wall motion abnormality. Among them, 24 cases were proved by operation (accuracy of ultrasound 95.8%), 17 cases were examined by pathology, 17 cases underwent aortic valve replacement (15 cases of mechanical valve, 2 cases of biological valve), 2 cases underwent coronary artery bypass grafting at the same time. Mitral valve replacement and tricuspid valvuloplasty were performed in 2 patients with mitral valve disease. The results of operation and pathology showed that 8 cases were classified as type A by Hurwitz, 7 cases by type B, 1 case by type C and 1 case by type F, accounting for 5.9%. The prognosis of CQAV patients was closely related to left ventricular diameter and EF value. Conclusion Echocardiography can accurately diagnose four-lobe aortic valve malformation and its intracardiac complications, which is of great value in the selection of corresponding treatment and follow-up.
【作者单位】： 北京协和医学院 中国医学科学院心血管病研究所 北京阜外心血管病医院超声科;陕西省咸阳市第一人民医院;北京协和医学院 中国医学科学院心血管病研究所 北京阜外心血管病医院成人外科;61785部队门诊部;
【基金】：国家自然科学基金资助项目(No.81271583)
【分类号】：R654.2;R540.45
[Abstract]:Objective to investigate the characteristics of echocardiography in the diagnosis of congenital aortic four-lobe malformation (CQAV), and to summarize the clinical and postoperative follow-up of CQAV, and to evaluate its prognosis and related factors. Methods Transthoracic echocardiography, transesophageal echocardiography and transthoracic real-time three-dimensional echocardiography were used to observe the number, distribution, echo, opening and closing and hemodynamics of aortic valve. The operative patients were followed up for more than one year. Results among 69 patients with CQAV, 56 were male and 13 were female, the age was 275.57 cases were diagnosed by transthoracic echocardiography, 12 cases were diagnosed by transesophageal echocardiography, 9 cases were examined by real-time three-dimensional echocardiography at the same time. Echocardiography showed that all patients with CQAV had different degree of aortic regurgitation. In addition, there were 4 cases with mild aortic stenosis and 9 cases with definite segmental ventricular wall motion abnormality. Among them, 24 cases were proved by operation (accuracy of ultrasound 95.8%), 17 cases were examined by pathology, 17 cases underwent aortic valve replacement (15 cases of mechanical valve, 2 cases of biological valve), 2 cases underwent coronary artery bypass grafting at the same time. Mitral valve replacement and tricuspid valvuloplasty were performed in 2 patients with mitral valve disease. The results of operation and pathology showed that 8 cases were classified as type A by Hurwitz, 7 cases by type B, 1 case by type C and 1 case by type F, accounting for 5.9%. The prognosis of CQAV patients was closely related to left ventricular diameter and EF value. Conclusion Echocardiography can accurately diagnose four-lobe aortic valve malformation and its intracardiac complications, which is of great value in the selection of corresponding treatment and follow-up.
【作者单位】： 北京协和医学院 中国医学科学院心血管病研究所 北京阜外心血管病医院超声科;陕西省咸阳市第一人民医院;北京协和医学院 中国医学科学院心血管病研究所 北京阜外心血管病医院成人外科;61785部队门诊部;
【基金】：国家自然科学基金资助项目(No.81271583)
【分类号】：R654.2;R540.45
【共引文献】
相关期刊论文 前10条
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