经食管二维超声心动图在二尖瓣成形术中的临床应用

Application study of two-dimensional transesophageal echocardiography in mitral valvuloplasty

目的评价经食管二维超声心动图(2D-TEE)在二尖瓣成形术中的临床应用价值。方法共收集二尖瓣脱垂并中度以上返流行心脏外科二尖瓣成形手术的患者35例。术中行2D-TEE检测二尖瓣病变类型与扇叶分区定位,与手术发现进行对照,并于术后即刻评价二尖瓣成形手术效果。结果 35例患者中发现病变部位共40处,36处病变部位与术中所见相符(符合率90%),其中5例(14%)术后监测发现2级以上瓣膜返流,立即改行人工瓣置换术。结论 2D-TEE在二尖瓣成形术中具有对病变部位分区定位、指导术式选择,具有缩短手术时间、提高手术成功率的重要临床应用价值。

Objective To evaluate the clinical application value of two -dimensional transesophageal echocardiography （2D - TEE） in intraoperative mitral valvuloplasty. Methods Totally 35 patients with mitral valve prolapse complicated with moderate or severe valvular regurgitation who underwent mitral valvuloplasty were included in this study. Routine transthoracic echocardiography was per- formed before surgery. The valvular lesion types, the location of scallops, and other findings were compared between the detection results of intraoperative 2D - TEE and the findings from the surgery. The final efficacy of mitral valvuloplasty were evaluated. Results Of the 35 cases, there were totally 40 involved mitral valve scallops were detected by 2D -TEE ;36 involved scallops （ 90% ） were consistent with the findings of surgery ;5 cases （ 14% ） were failed with mitral repair who underwent the artificial mitral valvular replacement because mi- tral valve regurgitations were or more than 2gradein immediately postoperative monitoring by 2D - TEE. Conclusion 2D - TEE has im- portant clinical application value in locating mitral valve involved scallops, guiding the selection of surgical approach, and shortening the surgery time. Finally,the successful rate of the mitral valvuloplasty is improved.