| 摘要: |
| 目的 分析和探讨经食管超声心动图(TEE)在围术期成人主动脉-心室通道中的价值。方法 回顾分析11例诊断主动脉-心室通道的超声心动图检查结果及临床特征,其中10例与手术结果对照,3例行病理学检测。结果 10例主动脉-心室通道中,包括ALVT I型2例、II型4例、III型3例,ARVT 1例,1例ALVT II型及2例ALVT III型病理检查显示通道囊袋结构为纤维组织增生伴局灶性黏液变性、坏死,周围组织为广泛玻璃样变伴急性炎性改变；外科矫治包括直接缝合、补片及人工瓣膜置换,3例ALVT因瓣周漏和/或补片处撕脱行二次手术,其中1例(伴感染性心内膜炎)二次术后再次瓣周漏,最终因心衰而死亡,其余预后良好。术前诊断TEE准确性高于TTE及CT,RT-3D可提供更加直观、生动的信息,iSlice在显示病变细节方面效果优于其他成像模式,TEE二维测值与术中测值相关性最好。结论 在成人主动脉-心室通道的术前诊断、术中监测及术后随访方面,TEE较TTE和CT效果更好。 |
| 关键词: 主动脉心室通道 主动脉左室通道； 经胸超声心动图 经食管超声心动图 |
| DOI： |
| 投稿时间：2019-12-06修订日期：2020-09-10 |
| 基金项目: |
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| Value of transesophageal echocardiography in perioperative period of adult aorto ventricular tunnel |
| HE Wenjiao,Jiangyan |
| () |
| Abstract: |
| ABSTRACT Objective To analyze and explore the value of transesophageal echocardiography in perioperative period of adult aorto ventricular tunnel . Methods The results of echocardiography and clinical features of 11 patients who had been diagnoesed as aorto ventricular tunnel were retrospectively analyzed, and 10 cases were compared with the surgical，2 cases were detected by pathology. Results There were 2 cases of ALVT with type I 、4 cases of ALVT with typeⅡ、3 cases of ALVT with typeIII and 1 case of ARVT. Pathological examination of 1 case of ALVT type II and 2 cases of ALVT type III showed that the cystic of the channel was fibrous tissue hyperplasia with focal myxosis and necrosis, and the tissue around the aortic valve was extensive hyaline degeneration with acute inflammatory change. Suture, patch and prosthetic valve replacement were performed according to the severity of each lesion and associated malformation. 3 patients with ALVT underwent secondary operation due to perivalvular leakage and / or avulsion of patch, and 1 patient (with infective endocarditis) died of heart failure after the second operation. ALL the other patients have a good prognosis. The diagnostic accuracy of TEE is higher than TTE and CT. Real-time three-dimensional can provide more intuitive and vivid information, and islice is better than other imaging mode in lesion detail. The correlation between the measurement of two-dimensional TEE and operation is the best. Conclusion TEE is better than TTE and CT in preoperative diagnosis，intraoperative monitoring and postoperative follow-up of aorto ventricular tunnel . |
| Key words: Aorto ventricular tunnel, Aorto-left ventricular tunnel, Transthoracic echocardiography, Transesophageal echocardiography |
