【摘要】 目的探讨实时三维经食管超声(RT3D TEE)在二尖瓣反流(MR)Carpentier’s分型中的应用价值。方法 RT3D TEE检查中度及以上MR患者共124例,按照Carpentier’s分型分为Ⅰ~Ⅲ型,并随访手术例数和术式。结果 124例患者中Carpentier’sⅠ型9例,其中心房颤动8例,二尖瓣裂1例;Ⅱ型102例,其中单纯二尖瓣脱垂16例,二尖瓣腱索断裂伴脱垂80例,感染性心内膜炎6例;Ⅲ型13例,Ⅲa型风湿心脏病8例,Ⅲb型左心收缩功能减低5例。MR患者接受手术治疗101例,其中二尖瓣成形术83例,瓣膜置换18例。结论 RT3D TEE可对不同类型MR进行精确评价,并对易混淆病变起鉴别作用,可为临床治疗提供客观依据。更多还原

【Abstract】 Objective To evaluate the feasibility of real-time three-dimensional transesophageal echocardiography(RT3D TEE)in Carpentier’s classification of patients with mitral regurgitation(MR).Methods Totally 124 patients with MR were divided into type I—Ⅲtype according to Carpentier’s classification,and the cases and methods of operation were followed up.Results In all of the 124 patients,9 cases were Carpentier’s type Ⅰ,including 8cases of atrial fibrillation,1case of mitral valve cleft;102patients were typeⅡ,including pure mitral valve prolapse in 16 cases,mitral valve prolapse with chordae rupture in 80 cases,infective endocarditis in 6 cases;13cases were type Ⅲ,including Ⅲa type rheumatic heart disease in 8 cases,Ⅲb type of left ventricular systolic dysfunction in 5cases.Totally 101 cases underwent MR surgery,including mitral valve plasty in 83 cases and valve replacement in 18 cases.Conclusion RT3 DTEE is feasible and accurate in defining different types of MR,and it is useful to make management decisions and select the appropriate surgical strategy.更多还原