实时三维经食管超声心动图诊断人工主动脉瓣血管翳

左浩; 蒋沅洁; 苏建; 管雪; 邓曦; 龚思铭; 黄月; 高云华; 徐亚丽

doi:10.16016/j.1000-5404.201912015

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实时三维经食管超声心动图诊断人工主动脉瓣血管翳

临床医学 | 更新时间：2026-01-09

- 实时三维经食管超声心动图诊断人工主动脉瓣血管翳
- Real-time three-dimensional transoesophageal echocardiography for diagnosis of pannus of prosthetic aortic valve
- 第三军医大学学报 2020年42卷第8期页码：830-834
- 作者机构：
- 作者简介：
- 基金信息：
  
  陆军军医大学临床医学科研人才培养计划(2018XL3040)
- DOI：10.16016/j.1000-5404.201912015
  中图分类号：
- 收稿：2019-12-02，
  
  纸质出版：2020-04-30
- 稿件说明：
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左浩, 蒋沅洁, 苏建, 等. 实时三维经食管超声心动图诊断人工主动脉瓣血管翳[J]. 第三军医大学学报, 2020,42(8):830-834.

Hao ZUO, Yuanjie JIANG, Jian SU, et al. Real-time three-dimensional transoesophageal echocardiography for diagnosis of pannus of prosthetic aortic valve[J]. Journal of Third Military Medical University, 2020, 42(8): 830-834.
左浩, 蒋沅洁, 苏建, 等. 实时三维经食管超声心动图诊断人工主动脉瓣血管翳[J]. 第三军医大学学报, 2020,42(8):830-834. DOI： 10.16016/j.1000-5404.201912015.

Hao ZUO, Yuanjie JIANG, Jian SU, et al. Real-time three-dimensional transoesophageal echocardiography for diagnosis of pannus of prosthetic aortic valve[J]. Journal of Third Military Medical University, 2020, 42(8): 830-834. DOI： 10.16016/j.1000-5404.201912015.

摘要

Abstract

Objective

To assess the value of real-time three-dimensional transoesophageal echocardiography (RT-3DTEE) in the diagnosis of pannus of prosthetic aortic valve.

Methods

A total of 89 patients with valve obstruction after receiving aortic valve replacement in our hospital were recruited between September

2017 and September

2019. All the patients underwent a second valve replacement

and the data of transthoracic echocardiography (TTE)

transesophageal echocardiography (TEE) and RT-3DTEE of these patients were analyzed.

Results

Of the 89 patients with valve obstruction

51 were diagnosed to have pannus with a mean thickness of 6.5±1.1 mm in the prosthetic aortic valve as confirmed by pathological examination of the surgical specimen. The thickness of the pannus measured by RT-3DTEE

TTE and TEE were 6.2±1.2 mm

5.1±1.2 mm

and 5.5±1.3 mm

respectively. The measurement by RT-3DTEE was well correlated with that on the surgical specimens (

0.01)

and the correlation was significantly better that of TTE and TEE (

0.05). The thickness of the pannus measured by RT-3

DTEE also differed significantly from that by TTE and TEE (

0.05). For the diagnosis of pannus

the sensitivity

specificity

positive predictive value and negative predictive value of RT-3DTEE were 84.3% 92.1%

93.5% and 81.4%

respectively

significantly higher than those of TTE (41.1%

89.5%

84.0% and 53.1%

respectively) and TEE (64.1%

89.5%

89.2% and 64.4%

respectively;

0.05). The pannus detected by RT-3DTEE occurred most commonly in the right anterior quadrant

with a circumference of 18.4±5.2 mm

an area of 0.79±0.28 cm

and a mean transaortic pressure gradient of 38±12 mmHg. The pannus area measured by RT-3DTEE was well correlated with the mean transaortic pressure gradient of the prosthetic valve; the degree of valve occlusion could be assessed based on the measured pannus area and the mean transaortic pressure gradient of the prosthetic aortic valve.

Conclusion

RT-3DTEE can improve the sensitivity and specificity of ultrasonic diagnosis of pannus in the prosthetic aortic valve and allows accurate evaluation of the degree of valve obstruction caused by the pannus

thus providing reliable evidence to facilitate the diagnosis and treatment of the condition.

关键词

Keywords

references

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