超声心动图在人工机械瓣卡瓣诊断中的临床应用

目的分析人工机械瓣卡瓣的超声图像特点,探讨超声心动图在人工机械瓣卡瓣诊断中的临床价值。方法 7例人工机械瓣卡瓣患者,超声心动图观察以下内容:1机械瓣瓣叶回声及活动情况;2通过机械瓣口的血流情况;3瓣口血流频谱,估算机械瓣口面积。结果人工机械瓣卡瓣位于二尖瓣6例,主动脉瓣1例。其中6例超声心动图即可清晰显示人工机械瓣叶活动受限,瓣环或瓣叶增厚,回声不光滑,血流束减少或变细,流束与瓣环平面夹角变小。频谱显示瓣口峰值流速及压差较正常增加,瓣口面积减小,术中所见与超声探查结果完全相符。患者均行再次换瓣手术。结论超声心动图是无创、快速诊断人工机械瓣卡瓣的首选方法。

Application of echocardiography in the diagnosis of stuck prosthetic valve leaflet

Objective To analyze the ultrasonography features of stuck prosthetic valve leaflet and discuss clinical value of echocardiography in the diagnosis of stuck prosthetic valve leaflet. Methods Echocardiography was performed in 7 patients with stuck valve leaflet and such aspects were observed as follows： the number, echo reflection and movement of mechanical valve leaflet;blood flow through mechanical valves;flow spectrum, estimate the area of valve orifice. Results In 6 of the 7 cases, struck valve was located in mitral valve, and in the rest one, it was in aortic valve. Transthoracic echocardiography can clearly display the limitation of activity of valves, thickening and rough of valve ring or leaflet, reduction and thin of the blood flow, the reduction of angle between blood flow and annular plane. Peak velocity and pressure difference were increased but valve area was decreased compared with those under normal state. The echocardiography findings were completely consistent with those observed during operation. All patients received valve replacement operation again. Conclusion Transthoracic echocardiography is the preferred method for the non-invasive, rapid diagnosis of stuck valve leaflet.