超声诊断Bentall术后冠状动脉吻合口漏并假性动脉瘤形成的价值探讨

Diagnostic value of echocardiography in coronary anastomotic leakage and pseudoaneurysm formation after Bentall operation

目的探讨超声在Bentall术后冠状动脉吻合口漏并假性动脉瘤形成诊断中的应用价值。方法选取我院Bentall术后经主动脉造影检查确诊且超声提示冠状动脉吻合口漏并假性动脉瘤形成的16例患者,总结其二维超声及彩色多普勒超声征象,并与主动脉造影结果进行对比分析。结果16例患者人工血管周围二维超声均可探及搏动性无回声区;冠状动脉吻合口处彩色多普勒可显示异常血流信号,其中左侧9例,右侧7例;瘤体均位于人工血管旁。经胸超声测量假性动脉瘤瘤体最大径和漏口处血流束宽度与主动脉造影诊断结果比较差异均无统计学意义。结论超声可以准确诊断Bentall术后冠脉吻合口漏及并发的假性动脉瘤,可作为临床随访检查的首选方法。

Objective To explore the application value of echocardiography in coronary anastomotic leakage and pseudoaneurysm after Bentall’s operation.Methods Sixteen patients were diagnosed with coronary anastomotic leakage and pseudoaneurysm after Bentall surgery in our hospital were enrolled,and their two-dimensional and color Doppler echocardiography findings were analyzed.The results of echocardiographic diagnosis was compared with aortic angiography.Results Two-dimensional echocardiography can detect the pulsating anechoic zone around the artificial blood vessels in 16 patients,and color Doppler can show abnormal blood flow signals at the anastomotic stoma of the coronary artery.There were 9 patients occurred in the left anastomosis and 7 patients occurred in the right side.There were no significant difference in the diameter of pseudoaneurysm and the coronary anastomotic leakage between echocardiography and aortic angiography.Conclusion Echocardiography can detect Bentall’s postoperative coronary anastomotic leakage and concurrent pseudoaneurysm accurately,which can be used as the first choice for clinical follow-up examination.