三维食管超声指导下经导管主动脉瓣置换术治疗感染性心内膜炎致主动脉瓣关闭不全1例

李昱茜; 孟欣; 白炜; 曹亮; 杜蒙蒙

doi:10.13201/j.issn.1001-1439.2022.07.015

三维食管超声指导下经导管主动脉瓣置换术治疗感染性心内膜炎致主动脉瓣关闭不全1例

- 空军军医大学第一附属医院(西京医院)超声医学科(西安，710032)
基金项目:
陕西省创新能力支撑计划-科技创新团队项目(No: 2020TD-034)

详细信息

通讯作者: 孟欣，E-mail：mxfmmu@163.com

中图分类号: R542.5

收稿日期: 2021-12-14

刊出日期: 2022-07-13

Aortic valve insufficiency caused by infective endocarditis was treated by transcatheter aortic valve replacement under the guidance of three-dimensional transesophageal echocardiography: one case report

- Department of Ultrasound Medicine, The First Affiliated Hospital of Air Force Military Medical University(Xijing Hospital), Xi'an, 710032, China

More Information

Corresponding author: MENG Xin, E-mail: mxfmmu@163.com

Received Date: 14 December 2021

Publish Date: 13 July 2022

摘要

摘要: 经导管主动脉瓣置换术(TAVR)是一种择期手术。本例患者因感染性心内膜炎所致急性主动脉瓣穿孔脱垂，合并多器官功能衰竭，紧急行TAVR。术前未进行多层螺旋CT检查。通过三维经食管超声心动图(TEE)对患者主动脉根部结构进行分析测量，完成瓣膜尺寸的选择。TEE在整个手术过程中监测和指导瓣膜释放，并在手术后立即评估疗效。术后9个月随访，超声心动图示患者恢复良好。
- 三维经食管超声 /
- 感染性心内膜炎 /
- 主动脉瓣关闭不全 /
- 经导管主动脉瓣置换术
Abstract: Transcatheter aortic valve replacement(TAVR) is an elective operation. In this case, the patient had acute aortic valve perforation and prolapse caused by infective endocarditis, combined with multiple organ failure, so TAVR was performed urgently. Multislice CT examination was not performed before operation. The patient's aortic root structure was analyzed and measured by three-dimensional transesophageal echocardiography(3D-TEE) to complete the selection of valve size. TEE monitored and guided the valve release throughout the operation, and evaluate the efficacy immediately after operation. The patient recovered well in follow-up 9 months.
- three-dimensional transesophageal echocardiography /
- infective endocarditis /
- aortic insufficiency /
- transcatheter aortic valve replacement

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图 1 二维TEE图像

Figure 1. 2D TEE image

下载: 全尺寸图片幻灯片

图 2 三维TEE图像

Figure 2. 3D TEE image

下载: 全尺寸图片幻灯片

图 3 瓣膜释放后人工瓣瓣周反流

Figure 3. Paravalvular regurgitation of prosthetic valve after valve release

下载: 全尺寸图片幻灯片

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