三维经食管超声评估二尖瓣成形环大小的可行性研究

Feasibility study of evaluating mitral valve annuloplasyt ring size by three-dimensional transesophageal

目的通过三维经食管超声(3D-TEE)测量二尖瓣前叶瓣环三角区距离预估二尖瓣成形术中成形环大小的可行性。方法选择2018年10月至2021年1月于我院接受二尖瓣成形术治疗二尖瓣关闭不全的60例患者。所有患者均在建立体外循环前行术前食道超声检查,并应用三维重建模式测量二尖瓣前叶瓣环纤维三角区距离,术后将该数据与术中外科医生用测环器测量选用的成形环大小进行比较以评估术前3D-TEE测量二尖瓣前叶三角区距离是否可作为二尖瓣成形术前评估成环大小的一种可选方法。结果54例术后即时评估二尖瓣反流程度为轻微或无二尖瓣反流,这54例在术前3D-TEE测量二尖瓣前叶瓣环纤维三角区距离的数值与术中测环器测量所选用成形环大小数值一致,两种测量方法之间的相关性及一致性高。结论3D-TEE测量二尖瓣前叶瓣环三角区距离可作为二尖瓣成形术中成形环大小选择的一种术前评估方式。

Objective To estimate the feasibility of ring size in mitral valvuloplasty using 3D transesophageal echocardiography(3D-TEE)to measure the distance between the anterior lobe of the mitral ring.Methods A total of 60 patients who underwent mitral valvuloplasty for mitral regurgitation from October 2018 to January 2021 were selected.Preoperative esophageal ultrasonography was performed in all patients before the establishment of cardiopulmonary bypass,and three-dimensional reconstruction model was used to measure the distance of mitral valve anterior annulus fiber trigone.This data was compared with the intraoperative measurement of the selected ring size by the surgeon using a ring gauge to evaluate whether preoperative 3D-TEE measurement of the anterior trigonal distance of the mitral valve could be an alternative method for evaluating the ring size before mitral valvular plasty.Results The degree of mitral regurgitation in 54 cases was evaluated immediately after operation as slight or no mitral regurgitation.The value of the fiber triangle distance of the anterior mitral valve ring measured by 3D-TEE before operation was consistent with the size of the formed ring measured by the intraoperative ring tester.The correlation and consistency between the two measurement methods were high.Conclusion 3D transesophageal ultrasound(3D-T-EE)measureing the triangular distance of the anterior mitral valve ring can be used as an alternative for the size of the mitral valve ring during mitral valve plasty preoperative assessment.