摘要: |
目的: 探讨经胸超声心动图诊断二叶式主动脉瓣畸形(BAV)及合并症的临床意义。
方法: 回顾性分析43例经胸超声诊断BAV及分型、瓣膜病、主动脉扩张及心内畸形等合并症并经外院食管超声与手术证实。
结果: 43例初诊BAV患者经外院手术(17例)或经食管超声(24例)确诊41例,2例误诊,超声诊断符合率93%。左、右冠瓣融合(L-R)型29例(70.7%),右、无冠瓣融合(R-N)型10例(24.4%),左、无冠瓣融合(L-N)型2例。主动脉扩张16例(39%)。单纯BAV不伴狭窄、关闭不全4例(9.7%);主动脉瓣轻度狭窄16例(39%),轻度关闭不全4例(9.7%);17例手术(41.6%)中包括中-重度狭窄伴关闭不全10例(24.4%),轻度狭窄伴重度关闭不全及赘生物形成2例,主动脉瓣中重度关闭不全5例(12.2%)。其他心内畸形4例。研究证实,L-R型发生瓣膜病、主动脉扩张比率最高。手术组患者年龄显著高于未手术组,P<0.05。
结论:经胸超声能提供BAV的超声分型,明确合并瓣膜病、主动脉扩张及其他心内畸形情况,为手术适应症选择与治疗提供全面准确的信息,是BAV及合并症确诊与随访的首选检测手段。 |
关键词: 二叶式主动脉瓣 经胸超声心动图 合并症 |
DOI: |
投稿时间:2018-01-16修订日期:2018-02-06 |
基金项目: |
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Clinical values on the diagnosis of congenital bicuspid aortic valve and its complications with trans-thoracic echocardiography |
caixingwen |
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Abstract: |
Objectives: To explore the clinical values on the diagnosis of congenital bicuspid aortic valve(BAV) and its complications with trans-thoracic echocardiography.
Retrospective studies were performed on the clinical values of the diagnosis on 43 cases of BAV, including the subtypes, the combined aortic stenosis, regurgitation, vegetation formation and the dilation of ascending aorta, which were confirmed by the trans-esophageal echocardiography and operations in the superior hospital.
Results: BAV of 41 over 43 cases were confirmed by TEE or operations in the higher level hospital, 19 cases were operated, and 24 cases were performed with TEE, only 2 cases were mis-diagnosed with a diagnostic accuracy of 93% on BAV with TTE. There were 29 cases of L-R infused type(70.7%), 10 in R-N infused and 2 in L-N type. Aorta dilation was observed in 16 cases. Operations were performed on 17 cases with 10 of aortic stenosis (AS, medium to severe) associated with aortic regurgitation(AR), 5 in aortic regurgitation(medium to severe) and 2 cases of mild AS+AR+vegetations. The other 24 cases were not appropriate for operations and need long-term follow–up due to intact or mild injured valves in stenosis or regurgitation.
Conclusions: Trans-thoracic echocardiography is the first approach on the screening and follow-up of the diagnosis and the associated complications of BAV, which can provide the detailed information on aortic valve and aorta to decide the operations indications and the strategies. |
Key words: Bicuspid aortic valve Complications Trans-thoracic echocardiography |