应用心脏彩超评价经导管主动脉瓣植入术对老年主动脉瓣狭窄患者的影响

Evaluation of the effect of transcatheter aortic valve implantation on elderly patients with aortic valve stenosis using cardiac color Doppler ultrasound

[目的]研究心脏彩超评价经导管主动脉瓣植入术(TAVI)对老年主动脉瓣狭窄患者的价值。[方法]选取我院2016年1月至2018年2月收治入院行TAVI的老年主动脉狭窄患者34例,分析患者基线资料和手术结果,比较术前与术后4周、术后12周心脏彩超各指标的结果。[结果]34例患者均顺利完成TAVI,无患者死亡;比较患者术前经胸超声心动图(TTE)、术中经食管超声心动图(TEE),主动脉瓣环内径、主动脉窦部内径、主动脉窦部高度、左室流出道内径和左室射血分数(LVEF)等指标测量值,差异无统计学意义(P>0.05);患者左室舒张末期内径在术前与术后4周、术后12周之间比较,差异无统计学意义(P>0.05),患者左室收缩末期内径、峰值跨瓣压差、平均跨瓣压差、LVEF和有效瓣口面积在术前与术后4周、术后12周之间比较,差异有统计学意义(P<0.05)。[结论]TAVI治疗老年严重主动脉瓣狭窄患者,疗效显著,在术前、术中和术后应用心脏彩超检查及随访具有重要意义。

[Objective]Explore the value of color Doppler ultrasound in evaluating transcatheter aortic valve implantation(TAVI)for elderly patients with aortic stenosis.[Methods]Thirty-four elderly patients with aortic stenosis who were admitted to our hospital from January 2016 to February 2018 for TAVI were selected.Analyze patient baseline data and surgical results,the results of cardiac color Doppler ultrasound were compared preoperatiely and 4 weeks and 12 weeks postoperatively.[Results]All 34 patients successfully completed TAVI without death.Compare patients with intrathoracic echocardiography(TTE)and intraoperative transesophageal echocardiography(TEE),aortic valve annulus diameter,aortic sinus diameter,aortic sinus height,left ventricular outflow tract inner diameter,and left ventricular ejection.fraction(LVEF)and other indicators measured values,the difference was not statistically significant(P>0.05).The left end diastolic diameter preoperatively and 4 weeks,12 weeks pootoperatively,there were no significiant different(P>0.05).The left ventricalar end systolic diameter,peak transvalvular pressure diffevence,average transvalvalar pressure difference,LVEF,and effective valve orifice area preoperatively and 4 weeks,12 weeks postoperatively,there were significiant difference(P<0.05).[Conclusion]TAVI is effective in treating elderly patients with severe aortic stenosis.The application of cardiac color Doppler ultrasound examination and follow-up before,during and after surgery has an important role.