CAJ | 학술논문

目的分析人工机械瓣膜功能异常,总结超声心动图在人工机械瓣功能异常诊断中的诊断价值.方法回顾分析52例人工机械瓣功能异常而再次手术患者术前、术中及术后随访超声心动图结果,并与外科手术或病理诊断结果对比.结果手术证实机械瓣功能异常病因:血栓12例,纤维组织增生23例,血栓合并纤维组织增生16例,机械碟片脱失1例.超声心动图诊断机械瓣功能异常:狭窄29例,关闭不全2例,狭窄并关闭不全12例,间歇梗阻8例,完全梗阻1例.经胸超声心动图显示机械瓣碟片运动状态的显示成功率为78.4％,联合经食管超声心动图机械瓣运动状态的显示成功率提高到96.1％,经食管超声心动图补充诊断10例,修正经胸超声心动图诊断1例.所有患者术后超声随访无再发人工瓣膜功能异常.结论超声心动图可作为机械瓣功能异常的首选影像学诊断方法,对人工瓣功能状态进行准确评估,联合经食管超声心动图可提高对碟片运动状态及病因的诊断准确率.
목적 분석인공궤계판막공능이상,총결초성심동도재인공궤계판공능이상진단중적진단개치.방법 회고분석52례인공궤계판공능이상이재차수술환자술전、술중급술후수방초성심동도결과,병여외과수술혹병리진단결과대비.결과 수술증실궤계판공능이상병인:혈전12례,섬유조직증생23례,혈전합병섬유조직증생16례,궤계설편탈실1례.초성심동도진단궤계판공능이상:협착29례,관폐불전2례,협착병관폐불전12례,간헐경조8례,완전경조1례.경흉초성심동도현시궤계판설편운동상태적현시성공솔위78.4％,연합경식관초성심동도궤계판운동상태적현시성공솔제고도96.1％,경식관초성심동도보충진단10례,수정경흉초성심동도진단1례.소유환자술후초성수방무재발인공판막공능이상.결론 초성심동도가작위궤계판공능이상적수선영상학진단방법,대인공판공능상태진행준학평고,연합경식관초성심동도가제고대설편운동상태급병인적진단준학솔.
Objective To evaluation the diagnostic value of echocardiography in mechanical prosthesis valve dysfunction(MPVD).Methods Fifty-two patients who underwent reoperation due to MPVD were included,and the preoperative,introperative and postoperative results of echocardiography was compared with the results of surgery or pathologic diagnosis.Results The etiology of MPVD based on cardiac surgery was thrombus in 12,fibrous tissue hyperplasia in 23,thrombus and fibrous tissue hyperplasia in 16,lost of mechanical disc in 1.The types of MPVD diagnosed by echocardiography were stenosis in 29,regurgitation in 2,stenosis and regrigitation in 12,intermittent obstruction in 8,and total obstruction in 1.Successful assessment of prosthetic disc by transthoracic echocardiography was 78.4％ and can be improved to 96.1 ％ when combined with transesophageal echocardiography.Complementary message by transesophageal echocardiography were provided in 10 patients and corrective message in 1 patient.No recurrent MPVD was find during the follow-up.Conclusions Echocardiography can be used as the frist choice for the evaluation of the MPVD and can make precise assessment of the abnormal hemodynamic change and state of motion of the valve.