全超声引导用于经导管二尖瓣缘对缘手术的应用研究

段福建; 龚俊松; 康文英; 李慧; 李世国; 张戈军; 王首正; 谢涌泉; 何爱霞; 房芳; 潘湘斌

doi:10.13201/j.issn.1001-1439.2023.08.002

全超声引导用于经导管二尖瓣缘对缘手术的应用研究

- 1.
  中国医学科学院阜外医院麻醉中心(北京，100021)
- 2.
  中国医学科学院阜外医院超声影像中心
- 3.
  中国医学科学院阜外医院结构中心
基金项目:
国家自然科学基金(No: 81970444); 国家高层次人才特殊支持计划(No: 202-RSW02); 中国医学科学院医学与健康科技创新工程(No: 2021-12M-1-065); 深圳三名工程“中国医学科学院阜外医院潘湘斌教授结构性心脏病团队”(No: SZSM202011013)

详细信息

通讯作者: 潘湘斌, E-mail: xiangbin428@hotmail.com

中图分类号: R541.3

收稿日期: 2023-07-24

刊出日期: 2023-08-13

Application of full ultrasound guidance in transcatheter edge-to-edge repair

- 1.
  Department of Anesthesiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
- 2.
  Department of Ultrasonography, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
- 3.
  Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China

More Information

Corresponding author: PAN Xiangbin, E-mail: xiangbin428@hotmail.com

Received Date: 24 July 2023

Publish Date: 13 August 2023

摘要

摘要: 目的对比全超声引导下实施经导管缘对缘手术与传统介入加超声引导方式对二尖瓣成形效果和钳夹质量的影响。方法回顾性分析24例正常对照组及全超声引导下行经导管缘对缘手术患者的相关参数，对比两组患者基线资料、二尖瓣成形效果和二尖瓣钳夹相关参数的差异。结果两组患者基线资料无统计学差异，与对照组相比，全超声引导下行经导管缘对缘手术的二尖瓣成形效果相当，同时二尖瓣钳夹相关参数未见统计学差异。结论与传统方式相比，全超声引导下进行经导管缘对缘手术在二尖瓣成形相关参数和手术钳夹质量等方面具有相似的临床效果。
- 经食管超声心动图 /
- 经导管缘对缘手术 /
- 二尖瓣反流 /
- 超声引导 /
- 二尖瓣成形
Abstract: Objective To compare the effect of transcatheter edge-to-edge repair(TEER) surgery on mitral valvuloplasty between full ultrasound guidance and traditional intervention plus ultrasound guidance.Methods The relevant parameters of 24 patients received TEER surgery between control group(under guidance of traditional intervention plus ultrasound guidance) and full ultrasound guided group were retrospectively analyzed. The baseline data of mitral valvuloplasty, the effect of mitral valvuloplasty, and clamp related parameters were compared between the two groups.Results There was no statistical difference in baseline data between the two groups. Compared with the control group, TEER surgery with full ultrasound guidance had the same effect of mitral valvuloplasty, while mitral valve clamp related parameters did not show any statistical difference.Conclusion Compared with control group, TEER surgery under full ultrasound guidance has similar clinical effects with traditional ways in terms of parameters of mitral valvuloplasty and clamp quality.
- transesophageal echocardiography /
- transcatheter edge-to-edge repair /
- mitral regurgitation /
- ultrasonic guidance /
- mitral valvuloplasty

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表 1 两组患者TEER手术基线资料

Table 1. Baseline data of TEER operation X±S, M(P₂₅, P₇₅)

项目	全超声引导组	对照组	P值
年龄/岁	72.67±3.87	71.83±4.86	0.621
男性/例(%)	8(66.67)	7(58.33)	0.999
体重/kg	66.25±9.70	65.42±10.26	0.840
身高/cm	165.7±7.76	165.3±9.13	0.905
BMI/(kg/m²)	24.05±2.30	23.88±2.67	0.875
NYHA心功能分级/例(%)
Ⅲ级	2(16.7)	3(25.0)	0.999
Ⅳ级	10(83.3)	9(75.0)	0.999
二尖瓣反流量/级	4(3.25，4.00)	4(4，4)	0.999
二尖瓣瓣口面积/cm²	6.05±0.54	6.03±0.53	0.940
二尖瓣平均压差/mmHg	1.17±0.39	1.25±0.4	0.633
射血分数/%	42.67±4.33	42.08±5.37	0.772

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表 2 两组患者TEER术后二尖瓣反流情况

Table 2. Mitral regurgitation after TEER X±S, M(P₂₅, P₇₅)

	全超声引导组	对照组	P值
术后二尖瓣反流量/级	1(1，2)	1(1，2)	0.999
术后二尖瓣瓣口面积/cm²	3.83±0.55	3.79±0.62	0.864
术后二尖瓣平均压差/mmHg	3.08±0.79	3.17±0.83	0.804
术后射血分数/%	47.42±4.54	46.75±5.14	0.740
术后NYHA心功能分级/例(%)
Ⅰ级	0	0	0.999
Ⅱ级	8(66.7)	7(58.3)	0.999
Ⅲ级	4(33.3)	5(41.7)	0.999
Ⅳ级	0	0	0.999

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表 3 两组患者TEER手术钳夹相关参数

Table 3. Related parameters of TEER surgical clamp X±S, M(P₂₅, P₇₅)

	全超声引导组	对照组	P值
手术时长/min	202.10±41.91	184.60±42.40	0.320
夹子数量/支	1(1，2)	1(1，2)	0.999
夹持失败/例(%)	0	0	0.999
单瓣夹持/例(%)	0	0	0.999
夹子脱落/例(%)	0	0	0.999
转开胸手术/例(%)	0	0	0.999

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