Bentall术后冠状动脉吻合口漏的超声心动图特征

Echocardiographic features of coronary anastomotic leakage after Bentall procedure

目的探讨Bentall术后冠状动脉吻合口漏的超声心动图特征,分析其诊断要点。方法选取2017年1月至2018年12月北京安贞医院收治,经超声诊断为Bentall术后冠状动脉吻合口漏且经CT血管造影(CTA)证实的患者38例,对其超声心动图结果进行回顾性分析,总结冠状动脉吻合口漏的声像图特征。结果冠状动脉吻合口漏的超声心动图结果主要表现为以下特征:冠状动脉吻合口处可见回声中断,缺口直径大小平均为(3.2±1.5)mm;吻合口处可探及彩色血流信号并可测得高速连续湍流频谱,峰值速度平均为(349±108)cm/s;人工血管与自体血管间可见分离暗区,分离宽度平均为(11.9±10.1)mm;部分患者(4/38,10.5%)可见异常血流信号经主动脉分流至右心房。结论超声心动图可对Bentall术后冠状动脉吻合口漏病变做出明确诊断,并可准确反映吻合口漏的大小、数目、血流等信息,为临床决策提供重要依据。

Objective To explore the echocardiographic features of coronary anastomotic leakage after Bentall operation,and summarize the key points of its diagnosis.Methods The echocardiographic features of 38 patients with coronary anastomotic leakage after Bentall operation diagnosed by echocardiography and confirmed by computed tomography angiography from January 2017 to December 2018 at Beijing Anzhen Hospital were retrospectively analyzed.Results The echocardiographic features of coronary anastomotic leakage were as follows:Gaps could be observed at the anastomotic site of the coronary artery,with a mean size of(3.2±1.5)mm;shunt and high-velocity signal could be detected by color and continuous wave Doppler ultrasound at the anastomotic site,with a mean peak velocity of(349±108)cm/s;echo-free areas could be observed between the artificial and autologous aorta,with an average width of(11.9±10.1)mm;and a shunt between the aorta and right atrium could be found in some cases,with an incidence of about 10.5%.Conclusion Echocardiography can be a useful tool for diagnosis of coronary anastomotic leakage,and can provide important information such as the size,number,and hemodynamics of leakage.