三维经食管超声心动图诊断降主动脉多发赘生物1例

A case of descending aorta multiple vegetations diagnosis by three-dimensional transesophageal echocardiography

本例患者术前经胸超声提示主动脉瓣、动脉导管及降主动脉赘生物形成,对于降主动脉拟行主动弓置换术。通过术前三维经食管超声提示降主动脉赘生物内基本已形成钙化,较为稳定,呈环形分布,未侵及毗邻血管壁,遂未对降主动脉进一步处理,仅行主动脉瓣赘生物清除、主动脉瓣置换、动脉导管缝扎及赘生物清除术。患者术后随访3个月未出现发热、肢体及重要脏器栓塞等症状。

The patient’s preoperative results of transthoracic echocardiography(TTE) indicated that vegetations were formed in the aortic valve, ductus arteriosus and descending aorta. Active arch replacement was planned for treating with the descending aorta. According to preoperative results from three-dimensional transesophageal echocardiography(3D-TEE), calcification was found in the vegetations of the descending aorta which was relatively stable. The calcification was distributed in a "ring" shape without adjacent blood vessels invaded. Therefore, no further treatment was performed on the descending aorta while aortic valve vegetation dissection, aortic valve replacement, ligation of patent ductus arteriosus and dissection of vegetations were performed. The followed-up was conducted for three months after the operation which no symptoms such as fever, limb and important organ embolism.