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经食管二维超声心动图在二尖瓣成形术中的应用

Keywords: 经食管,二维超声心动图描记术,二尖瓣成形术,疗效

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Abstract:

目的探讨经食管二维超声心动图(two-dimensionaltransesophagealechocardiography,2D-TEE)在二尖瓣成形术(mitralvalverepair,MVR)中的临床应用价值。方法40例二尖瓣关闭不全拟实施MVR患者,应用2D-TEE在术前对二尖瓣病变的病因进行诊断,术中监测,术后即刻评估瓣膜返流程度。结果二尖瓣关闭不全的病因有瓣膜黏液样退行性病变19例(47.50%),先天性二尖瓣病变10例(25.00%),感染性心内膜炎病变5例(12.50%),风湿性瓣膜病变4例(10.00%),缺血性病变导致二尖瓣关闭不全2例(5.00%)。40例患者中35例1次性手术成功,3例术后监测发现中度返流,再次行成形术终获成功,2例术后仍为重度返流改行二尖瓣人工瓣膜置换术。左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末期容量(LVEDV)、左心室收缩末期容量(LVESV)、左心室射血分数(LVEF)均较术前降低(P<0.05)。结论MVR术中应用2D-TEE有助于手术方式的选择及手术效果的评价。

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