主动脉瓣置换术后左室流出道流速增加患者超声观察

Echo-Doppler study on velocities increase of left ventricular outflow patients with arotic valve replacement

目的 :探讨主动脉瓣狭窄行换瓣术后左室流出道流速增加的发生机制和相关因素。方法 :5 0例严重主动脉瓣狭窄患者 ,男 2 8例 ,女 2 2例 ,年龄 16～ 5 8岁 ,主动脉瓣置换术后 1周内复查超声心动图 ,以左室流出道流速是否显著增加 (大于 2 .5m·s-1)将术后患者分成 2组 ,并对左室舒张末期内径、收缩末期内径、左室流出道内径、室间隔和左室后壁厚度进行对比分析。结果 :5 0例无手术死亡 ,9例左室流出道流速显著增加 ,其中 6例出现了二尖瓣瓣叶的前向运动现象。 2组除左室后壁厚度相比差异无统计学意义 (P >0 .0 5 )外 ,其余指标相比差异均有统计学意义 (P <0 .0 5或 0 .0 1)。结论 :主动脉瓣狭窄部分患者术后存在左室流出道流速增加 ,它与小左室舒张末径、收缩末径、流出道内径及增厚的室间隔有着显著关系。

Aim:To explore the mechanism and relation factors of velocities increase of left ventricular outflow following aortic valve replacement.Methods: A total of 50 patients with severe aortic valve stenosis were collected. Echo-Doppler study was performed one week after aortic valve replacement, and the patients were divided into two groups(Ⅰ,Ⅱ). GroupⅠ, systolic left ventricular velocities >2.5m·s -1 ;GroupⅡ, systolic left ventricular velocities <2.5 m·s -1 . The left ventricular end-diastolic dimensions, the left ventricular end-systolic dimensions, the left ventricular outflow tract, the thickness of septum and posterior wall were compared and analyze.Results: There was no operative mortality. The maximal left ventricular velocities increased significantly in 9 patients and six of them had SAM syndrome. Significant differences were observed between the two groups (P<0.05 or P<0.01) except the posterior wall of left ventricular.Conclusion: The velocities increase of left ventricular outflow following aortic valve replacement relates to the smaller systolic and diastolic diameters of the left ventricule and hypertrophy of septum.