经食管二维和三维超声心动图对二尖瓣人工机械瓣瓣周漏定位诊断价值

The value of two- and three-dimensional transesophageal echocardiography in identifying the mitral perivalvular leak

目的:探讨经食管实时二维和三维超声心动图诊断二尖瓣瓣人工机械瓣瓣周漏的临床价值。方法:回顾分析二尖瓣人工机械瓣瓣周漏26例的二维、三维经食管超声心动图表现特征,并与术中所见进行对比。结果:26例二尖瓣人工机械瓣瓣周漏患者,术中发现二尖瓣人工机械瓣瓣周漏36处,其中6例同时存在2处漏口,2例同时存在3处漏口。经食管实时三维超声心动图共发现瓣周漏30处,与术中发现符合率100%,二维经食管超声心动图共发现瓣周漏28处,与术中发现符合率77.8%。结论:经食管实时三维超声心动图能够清晰显示二尖瓣人工机械瓣瓣周漏的位置、形态和大小,有利于术前手术计划的选择和制定。

Objective: To investigate the clinical value of two-dimensional and real-time three-dimensional echocardiography in the diagnosis of perivalvular leakage of mitral valve prosthesis. Methods: The two-dimensional and three-dimensional transesophageal echocardiographic features of 26 patients with periprosthetic mitral valve leak were retrospectively analyzed and compared with the intraoperative findings. Results: Thirty-six perivalvular leaks were found in 26 patients, including 2 sites of leaks in 6 patients and 3 sites of leaks in 2 patients. Thirty-two perivalvular leaks were found by real-time three-dimensional transesophageal echocardiography, and the coincidence rate was 100%, compared with surgical findings. Twenty-eight perivalvular leaks were found by two-dimensional transesophageal echocardiography, and the coincidence rate was 77.8%. Conclusions: Transesophageal real-time three-dimensional echocardiography can clearly display the location, shape and size of the perivalvular leakage of mitral valve prosthesis, which is helpful to the selection and establishment of preoperative planning.