经胸与经食管超声心动图对心脏人工瓣膜的对比研究

Comparison of transthoracic and transesophageal echocardiography in patients with prosthetic cardiac valves

４７例心脏人工机械瓣膜置换术后的病人，经胸超声心动图（ＴＴＥ）和经食管超声心动图（ＴＥＥ）对比研究显示，低估二尖瓣置换后人工瓣膜返流程度的分级和返流的发生率；主动脉瓣和二尖瓣置换的病人，ＴＴＥ探查人工二尖瓣返流的效果硬差。ＴＥＥ能较容易地探查人工二尖瓣瓣周漏。揭示对人工二尖瓣的评价，ＴＥＥ比ＴＴＥ能提供更多更可靠的信息，毫无疑问这是由于ＴＴＥ检查时人工瓣膜材料的声衰减和血流掩盖的影响，但我们的经验揭示，在评价主动脉瓣置换人工瓣膜时，ＴＥＥ并不优于ＴＴＥ。

Forty-seven patients with prosthetic cardiac valves were studied comparatively with transthoracic and transesophageal echocardiography. The degree of the prosthetic regurgitation in mitral position was underestimated by the transthoracic echocardiography. The rate for prosthetic regurgitaion in mitral position was lower in patients with prostheic mitral and aortic valves than patients with only prosthetic mitral valve by transthoracic echocardiography. Paraprosthetic leaks in mitral position can easily be detected by transesophageal echocardiography .Thus, our data suggest that in patients with mitral prostheses, transesophageal echocardiography gives more reliable information than the conventional transthoracic approach. This is not surprising because there is unavoidable signal attenuation and flow masking by intervening prosthesis material with the transthoracic approach in majority of the patients. But our limited experience suggests that the transesophageal echocardiography may not be superior to the transthoracic approach in assessing aortic prostheses.