【摘要】：目的探討超聲心動圖對先天性主動脈瓣四葉畸形(CQAV)的診斷特點(diǎn),并總結(jié)CQAV的臨床和術(shù)后隨訪情況,評價(jià)其預(yù)后及相關(guān)因素。方法采用經(jīng)胸超聲心動圖、經(jīng)食管超聲心動圖及經(jīng)胸實(shí)時(shí)三維超聲心動圖觀察主動脈瓣葉數(shù)量、分布形態(tài)、回聲、啟閉及血流動力學(xué)情況,并對其中手術(shù)患者進(jìn)行超過1年的隨訪。結(jié)果 69例CQAV患者中,男56例,女13例,年齡2~75歲。57例為經(jīng)胸超聲心動圖確診,12例為經(jīng)食管超聲確診,其中9例同時(shí)行實(shí)時(shí)三維超聲心動圖檢查。超聲心動圖顯示CQAV患者均有不同程度的主動脈瓣反流,此外,有4例合并主動脈瓣輕度狹窄,9例有明確的節(jié)段性室壁運(yùn)動異常。CQAV主要以單純畸形為主者60例,占87%,其中24例經(jīng)手術(shù)證實(shí)(超聲準(zhǔn)確率95.8%),17例行病理檢查。17例患者行主動脈瓣置換術(shù)(機(jī)械瓣15例、生物瓣2例),其中2例同時(shí)行冠狀動脈旁路移植術(shù),2例因合并二尖瓣病變,同時(shí)行二尖瓣置換術(shù)及三尖瓣成形術(shù)。手術(shù)病理結(jié)果發(fā)現(xiàn):Hurwitz分型為A型8例,占47%,B型7例,占41.1%,C型及F型各1例,占5.9%。超聲對CQAV患者術(shù)后隨訪發(fā)現(xiàn),患者的預(yù)后與左室內(nèi)徑和EF值密切相關(guān)。結(jié)論超聲心動圖能夠準(zhǔn)確診斷四葉式主動脈瓣畸形及其心內(nèi)合并癥,對選擇相應(yīng)的治療方案和隨訪有著非常重要的價(jià)值。
[Abstract]:Objective to investigate the characteristics of echocardiography in the diagnosis of congenital aortic four-lobe malformation (CQAV), and to summarize the clinical and postoperative follow-up of CQAV, and to evaluate its prognosis and related factors. Methods Transthoracic echocardiography, transesophageal echocardiography and transthoracic real-time three-dimensional echocardiography were used to observe the number, distribution, echo, opening and closing and hemodynamics of aortic valve. The operative patients were followed up for more than one year. Results among 69 patients with CQAV, 56 were male and 13 were female, the age was 275.57 cases were diagnosed by transthoracic echocardiography, 12 cases were diagnosed by transesophageal echocardiography, 9 cases were examined by real-time three-dimensional echocardiography at the same time. Echocardiography showed that all patients with CQAV had different degree of aortic regurgitation. In addition, there were 4 cases with mild aortic stenosis and 9 cases with definite segmental ventricular wall motion abnormality. Among them, 24 cases were proved by operation (accuracy of ultrasound 95.8%), 17 cases were examined by pathology, 17 cases underwent aortic valve replacement (15 cases of mechanical valve, 2 cases of biological valve), 2 cases underwent coronary artery bypass grafting at the same time. Mitral valve replacement and tricuspid valvuloplasty were performed in 2 patients with mitral valve disease. The results of operation and pathology showed that 8 cases were classified as type A by Hurwitz, 7 cases by type B, 1 case by type C and 1 case by type F, accounting for 5.9%. The prognosis of CQAV patients was closely related to left ventricular diameter and EF value. Conclusion Echocardiography can accurately diagnose four-lobe aortic valve malformation and its intracardiac complications, which is of great value in the selection of corresponding treatment and follow-up.
【作者單位】： 北京協(xié)和醫(yī)學(xué)院 中國醫(yī)學(xué)科學(xué)院心血管病研究所 北京阜外心血管病醫(yī)院超聲科;陜西省咸陽市第一人民醫(yī)院;北京協(xié)和醫(yī)學(xué)院 中國醫(yī)學(xué)科學(xué)院心血管病研究所 北京阜外心血管病醫(yī)院成人外科;61785部隊(duì)門診部;
【基金】：國家自然科學(xué)基金資助項(xiàng)目(No.81271583)
【分類號】：R654.2;R540.45

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李金燕;李君;;實(shí)時(shí)三維超聲心動圖在心臟瓣膜病中的應(yīng)用[J];包頭醫(yī)學(xué);2009年03期

2 唐海霞;董t盆，

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