CAJ | 학술논문

目的：评估经食管超声及彩色血流显像对人工机械瓣膜正常及病理性反流的诊断价值。方法：分析2004-05~2014-02期间经TTE及TEE检查的人工机械瓣资料完整的病例52例,男25例,女27例,平均年龄44.66依5.09岁,其中二尖瓣位置机械瓣置换数52个,主动脉瓣位置机械瓣置换数27个,双瓣置换的重叠病例18例。二尖瓣位机械瓣反流分级标准以反流口缩流宽度划分。主动脉瓣位机械瓣的偏心性反流分级标准以Jet宽/LVO宽度划分,瓣周漏分级以漏口彩色血流占瓣环周长比率划分。结果：(1)二尖瓣替换病人,TTE显像诊断人工机械瓣二尖瓣正常及病理性反流的准确性为59.62%,低估率为28.85%,高估率为36.54%,漏检率为19.23%。(2)主动脉瓣替换病人,TTE诊断人工机械主动脉瓣正常及病理性反流的准确性为85.18%,低估率11.1%,高估率为14.81%。结论：TEE在评价人工机械瓣膜病理性反流方面尤其是对人工心脏机械瓣二尖瓣的评价优于经胸超声,起到了明确诊断的决定性作用。
목적：평고경식관초성급채색혈류현상대인공궤계판막정상급병이성반류적진단개치。방법：분석2004-05~2014-02기간경TTE급TEE검사적인공궤계판자료완정적병례52례,남25례,녀27례,평균년령44.66의5.09세,기중이첨판위치궤계판치환수52개,주동맥판위치궤계판치환수27개,쌍판치환적중첩병례18례。이첨판위궤계판반류분급표준이반류구축류관도화분。주동맥판위궤계판적편심성반류분급표준이Jet관/LVO관도화분,판주루분급이루구채색혈류점판배주장비솔화분。결과：(1)이첨판체환병인,TTE현상진단인공궤계판이첨판정상급병이성반류적준학성위59.62%,저고솔위28.85%,고고솔위36.54%,루검솔위19.23%。(2)주동맥판체환병인,TTE진단인공궤계주동맥판정상급병이성반류적준학성위85.18%,저고솔11.1%,고고솔위14.81%。결론：TEE재평개인공궤계판막병이성반류방면우기시대인공심장궤계판이첨판적평개우우경흉초성,기도료명학진단적결정성작용。
Objective:The aim of this study was to evaluate the diagnostic value of transesophageal echocardiography on normal and pathological regurgitation of prosthetic mechanical heart valve. Methods:Fifty-two patients were participated in the research,including twenty-five males and twenty-seven females at an average age of 44 . 66±5 . 09 . Patients with prosthetic mechanical heart valve in single mitral(n=52),single aortic(n=27),and mitral and aortic(n=18)positions were examined by transthoracic echocardiography( TTE ) and transesophageal echocardiography ( TEE ) . The standards of mitral regurgitation of prosthetic mechanical heart valve were assessed by the width of the vena contracta. The standards of aortic eccentric regurgitation were assessed by Jet/LVO width and aortic perivalvular leakage by the ratio of CDFI to perimeter of the aortic annulus respectively. Results:(1)Mitral replacement ( including bivalve replacement ):The accuracy in assessment of normal and pathological regurgitation of prosthetic mechanical heart valve by transthoracic echocardiography( TTE) was 59 . 62%;underestimation rate was 28 . 85%;overestimation rate was 36 . 54%;evade detection rate was 19. 23%. (2)Aortic replacement(including bivalve replacement):The accuracy in assessment of normal and pathological regurgitation of prosthetic mechanical heart valve by transthoracic echocardiography ( TTE ) was 85 . 18%;underestimation rate was 11 . 1%;overestimation rate was 14 . 81%. Conclusion:In the assessment of pathological regurgitation of prosthetic mechanical heart valve,especially in terms of mitral regurgitation, transesophageal echocardiography ( TEE ) is superior than transthoracic echocardiography( TTE) ,which plays a decisive role in definite diagnosis.