|
|
|
| Application value of real-time 3D-TEE in diagnosis and occlusion of mitral perivalvular leakage |
| WANG Hong-hu, ZHAO Xi, HOU Su-yun, XU Jian-wei, ZHAO Na, WANG Ling-yun, LIU Hui-ruo |
| Department of Ultrasound, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China |
|
|
|
|
Abstract Objective: To explore application value of real-time three-dimensional transesophageal echocardiography(3D-TEE) in the diagnosis and occlusion of mitral perivalvular leakage. Methods: Ten patients who diagnosed with mitral perivalvular leakage were selected in our hospital to underwent transthoracic echocardiography(TTE) and 3D-TEE. All patients with perivalvular leakage underwent closure guided by DSA or 3D-TEE. The width, length, and position of perivalvular leakage were measured by TTE and TEE. Results: There was no significant difference in the width of perivalvular leakage measured by TEE or TEE(P＞0.05). The length of perivalvular leakage measured by TEE was obviously longer than by TTE(P＜0.05). In the process of occlusion, 8 patients were guided by DSA and TTE, and 2 patients were guided by TEE only. The 3D-TEE is of great value in the selection and release of occlusion umbrella and the evaluation of residual shunt. Conclusions: TTE was used to preliminary screen of mitral perivalvular leakage. 3D TEE was used to accurately evaluate the mitral perivalvular leakage and release of occlusion umbrella.
|
|
Received: 30 December 2019
|
|
|
|
|
|
| [1]Biner S, Kar S, Siegel RJ, et al. Value of color Doppler three-dimensional transesophageal echocardiography in the percutaneous closure of mitral prosthesis paravalvular leak[J]. Am J Cardiol, 2010, 105(7): 984-989.
[2]金屏，赖盛伟，逯登辉，等. 瓣周漏介入封堵治疗的安全性和有效性[J]. 心脏杂志，2019，31（1）：22-27.
[3]Branny M, Januka J, Kňouil L, et al. Management of paravalvular leaks[J]. Coret Vasa, 2012, 54(3): e151-e155.
[4]Lonescu A, Fraser AG, Butchart EG. Prevalence and clinical significance of incidental paraprosthetic valvar regurgitation: a prospective study using transoesophageal echocardiography[J]. Heart, 2003, 89(11): 1316-1321.
[5]朴雪梅，薛超，谷孝艳，等. 经食管二维和三维超声心动图对二尖瓣人工机械瓣瓣周漏定位诊断价值[J]. 心肺血管病杂志，2019，38（6）：669-672.
[6]王崇，韩林，陆方林，等. 再次心脏瓣膜手术325例临床分析[J]. 中国胸心血管外科临床杂志，2013，2013（1）：24-28.
[7]Hourihan M, Perry SB, Mandell VS, et al. Transcatheter umbrella closure of valvular and paravalvular leaks[J]. J Am Coll Cardiol, 1992, 20(6): 1371-1377.
[8]Ruiz CE, Hahn RT, Berrebi A, et al. Clinical trial principles and endpoint definitions for paravalvular leaks in surgical prosthesis: an expert statement[J]. J Am Coll Cardiol, 2017, 69(16): 2067-2087.
[9]Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease[J]. Eur Heart J, 2017, 38(36): 2739-2791.
[10]Ruiz CE, Hahn RT, Berrebi A, et al. Clinical trial principles and endpoint definitions for paravalvular leaks in surgical prosthesis: an expert statement[J]. J Am Coll Cardiol, 2017, 69(16): 2067-2087.
[11]徐臣年，刘洋，李晓峰，等. 二尖瓣置换术后瓣周漏的介入治疗效果分析[J]. 中华心血管病杂志，2016，21（3）：238-243.
[12]康彧，唐红. 经食管实时三维超声心动图的临床应用[J]. 中国临床医学影像杂志，2010，21（7）：493-495.
[13]孔令秋，唐红. 经食管实时三维超声心动图在结构性心脏病介入治疗中的应用[J]. 中华临床医师杂志：电子版，2012，6（20）：127-129.
[14]Gürsoy OM, Astarcolu MA, Gkdeniz T, et al. Severe mitral paravalvular leakage: echo-morphologic description of 47 patients from real-time three-dimensional transesophageal echocardiography perspective[J]. Anadolu Kardiyol Derg, 2013, 13(7): 633-640. |
|
|
|
