超声心动图评价二尖瓣狭窄的术后状态。

Journal of cardiography Pub Date : 1986-06-01
N Hibi, Y Takashina, K Miyajima, T Nishida, Y Okamoto, S Kobayashi, Y Kakinuma, T Kambe
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引用次数: 0

摘要

超声心动图比较109例二尖瓣狭窄(MS)患者的术前和术后表现,并评估术后状态,其中22例行闭合性二尖瓣合拢切开术(CMC)(34.3±6.9 y.o);71、开放式二尖瓣合骨切开术(OMC)(42.9±8.7);16、二尖瓣置换术(MVR)(44.5±8.9)。术前1 - 2周及术后约1个月,采用东芝sl - 51h机械扇形扫描仪或SSH-11A相控阵电子扇形扫描仪进行超声心动图检查,每年复查一次。结果表明:CMC组和OMC组心脏手术后二尖瓣前叶(AML)的E-F斜率和二尖瓣口面积(MVA)均显著增加。CMC组二尖瓣的振幅略有增加,而OMC组没有变化。术前MVR组左房维数(LAD)大于其他两组,手术干预后三组左房维数均显著降低。多数患者主动脉尺寸(aortic dimension, AOD)略有增加,且由于心功能的改善和左房增大的解决,心脏手术后主动脉尺寸与主动脉与左房尺寸之和的比值[AOD/(AOD + LAD)]明显增加。重复超声心动图有助于二尖瓣状态和心脏表现的随访,并被认为是确定再次手术指征的有用的。
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[Mitral stenosis of the postoperative state evaluated by echocardiography].

Echocardiography was performed to compare pre- and postoperative findings and to evaluate the postoperative state in 109 patients with mitral stenosis (MS) including 22 who underwent closed mitral commissurotomy (CMC) (34.3 +/- 6.9 y.o.); 71, open mitral commissurotomy (OMC) (42.9 +/- 8.7 y.o.); and 16, mitral valve replacement (MVR) (44.5 +/- 8.9 y.o.). Echocardiographic examinations were performed using a Toshiba SSL-51H with a mechanical sector scanner or an SSH-11A with a phased-array electronic sector scanner, one or two weeks before and about one month after surgery, and were reviewed yearly. The results were as follows: The E-F slope of the anterior mitral leaflet (AML) and mitral valve orifice area (MVA) were significantly increased after cardiac surgery in both the CMC and OMC groups. The amplitude of the mitral valve was slightly increased in the CMC group, but was unchanged in the OMC group. Before surgery, the left atrial dimension (LAD) was larger in the MVR group than in the other two groups, and it was significantly decreased after surgical intervention in all three groups. The aortic dimension (AOD) was slightly increased in the majority of patients, and the ratio of the aortic dimension to the sum of the aortic and left atrial dimensions [AOD/(AOD + LAD)] was significantly increased after cardiac surgery due to the improvement of cardiac function and the resolution of the left atrial enlargement. Repeated echocardiography facilitated follow-up of the state of the mitral valve and of cardiac performance, and is considered useful in determining indication for reoperation.

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