经食管超声心动图在心脏介入手术中的临床应用价值

郭影; 钟小芳; 林小璇; 余妙如; 刘莹莹

doi:10.13201/j.issn.1001-1439.2023.08.004

经食管超声心动图在心脏介入手术中的临床应用价值

- 暨南大学第二临床医学院(深圳市人民医院)(广东深圳，518020)
基金项目:
国家自然科学基金青年项目(No: 82102041); 深圳市科技创新委员会国际合作研究项目(No: GJHZ 20210705142205017, GJHZ 20210705142206019); 深圳市科技创新委员会基础研究面上项目(No: JCYJ 20210324113804013)

详细信息

通讯作者: 刘莹莹, E-mail: yingyingliu@ext.jnu.edu.cn

中图分类号: R541.3

收稿日期: 2023-07-20

刊出日期: 2023-08-13

Clinical value of transesophageal echocardiography in interventional cardiac surgery

- Shenzhen People's Hospital, the Second Clinical College of Jinan University, Shenzhen, Guangdong, 518020, China

More Information

Corresponding author: LIU Yingying, E-mail: yingyingliu@ext.jnu.edu.cn

Received Date: 20 July 2023

Publish Date: 13 August 2023

摘要

摘要: 本文阐述了经食管超声心动图(transesophageal echocardiography，TEE)在常见的心脏介入手术中的临床应用及其较传统手术的优势，常见的心脏介入手术主要包括经导管瓣膜置换术、经导管瓣膜修复术、球囊扩张术及先天性心脏病介入封堵术等。利用TEE引导心脏介入治疗，不仅避免了X线的暴露，还可以实时监测手术进程和指导手术操作，体现了TEE在心脏介入治疗中有着无法比拟的技术优势与应用价值。
- 经食管超声心动图 /
- 心脏介入手术 /
- 经导管瓣膜置换术 /
- 经导管瓣膜修复术 /
- 封堵术
Abstract: This paper describes the clinical application of transesophageal echocardiography(TEE) in common cardiac intervention treatment and its advantages compared with traditional surgery. The common intervention mainly includes transcatheter valve replacement, transcatheter valve repair, balloon dilation and interventional closure of congenital heart disease. The use of TEE to guide cardiac interventional therapy not only avoids X-ray exposure, but also monitors the surgical process and guides the surgical operation in real time, which reflects the unparalleled technical advantages and application value of TEE in cardiac intervention.
- transesophageal echocardiography /
- cardiac interventional surgery /
- transcatheter valve replacement /
- transcatheter valve repair /
- occlusion

HTML全文

图 1 ^[7]超声心动图评估

Figure 1. Echocardiographic assessment

下载: 全尺寸图片幻灯片

图 2 ^[17] MitraClip置入术后的三维及血流多普勒图像

Figure 2. Three-dimensional and blood flow Doppler images after MitraClip implantation

下载: 全尺寸图片幻灯片

图 3 ^[24] ASD封堵手术前后经食管二维及三维超声心动图

Figure 3. Two and three-dimensional transesophageal echocardiography before and after ASD closure surgery

下载: 全尺寸图片幻灯片

图 4 ^[28] 2D-TEE各角度左心耳开口径及深度

Figure 4. Opening diameter and depth of left auricle at different angles of 2D-TEE

下载: 全尺寸图片幻灯片

参考文献(29)

[1]	胡盛寿. 中国心脏外科学面临的挑战和机遇[A]. 中华医学会胸心血管外科学分会. 中华医学会第六次全国胸心血管外科学术会议论文集(胸外科分册)[C]. 中华医学会胸心血管外科学分会: 中华医学会, 2006: 32-36.
[2]	丁琳, 朱斌. 经食管超声心动图在心脏介入治疗中的应用[J]. 临床麻醉学杂志, 2019, 35(1): 94-97. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMZ201901029.htm
[3]	郭颖, 张瑞生. 中国成人心脏瓣膜病超声心动图规范化检查专家共识[J]. 中国循环杂志, 2021, 36(2): 109-125. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH202102003.htm
[4]	经食管超声心动图临床应用中国专家共识专家组. 经食管超声心动图临床应用中国专家共识[J]. 中国循环杂志, 2018, 33(1): 11-23. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH201801003.htm
[5]	Zamorano JL, Badano LP, Bruce C, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease[J]. Eur Heart J, 2011, 32(17): 2189-2214. doi: 10.1093/eurheartj/ehr259
[6]	Prihadi EA, van Rosendael PJ, Vollema EM, et al. Feasibility, accuracy, and reproducibility of aortic annular and root sizing for transcatheter aortic valve replacement using novel automated three-dimensional echocardiographic software: comparison with multi-detector row computed tomography[J]. J Am Soc Echocardiogr, 2018, 31: 505-514. e3. doi: 10.1016/j.echo.2017.10.003
[7]	李娜娜, 朱向明, 胡国兵. 超声心动图在经导管主动脉瓣置换术中的应用价值[J]. 临床超声医学杂志, 2023, 25(1): 34-38. https://www.cnki.com.cn/Article/CJFDTOTAL-LCCY202301007.htm
[8]	Mylotte D, Piazza N. Transcatheter mitral valve implantation: a brief review[J]. Euro Intervention, 2015, 11 Suppl W: W67-70.
[9]	Cohen DJ, Ludwig S, Piazza N. Transcatheter mitral valve replacement will remain a niche therapy: pros and cons[J]. Euro Intervention, 2023, 18(15): 1222-1225.
[10]	Hensey M, Brown RA, Lal S, et al. Transcatheter mitral valve replacement: an update on current techniques, technologies, and future directions[J]. JACC Cardiovasc Interv, 2021, 14(5): 489-500. doi: 10.1016/j.jcin.2020.12.038
[11]	Nkomo VT, Gardin JM, Skelton TN, et al. Burden of valvular heart diseases: a population-based study[J]. Lancet, 2006, 368(9540): 1005-1011. doi: 10.1016/S0140-6736(06)69208-8
[12]	Pan W, Zhou D, Wu Y, et al. First-in human results of a novel userfriendly transcatheter edge-to-edge mitral valve repair[J]. JACC Cardiovasc Interv, 2019, 12(23): 2442-2443.
[13]	Ge Z, Pan W, Zhou D, et al. Effect of a novel transcatheter edge-to-edge repair device on the three-dimensional geometry of mitral valve in degenerative mitral regurgitation[J]. Catheter Cardiovasc Interv, 2021, 97(1): 177-185.
[14]	Liu X, Pu Z, Lim DS, et al. Transcatheter mitral valve repair in a high-surgical risk patient with severe degenerative mitral regurgitation using the novel DragonFly^TM Transcatheter Repair device-First in man implantation in China[J]. Catheter Cardiovasc Interv, 2022, 99(2): 518-521.
[15]	Liu X, Chen Y, Lim DS, et al. Transcatheter mitral valve repair in patient with atrial functional mitral regurgitation using novel DragonFly^TM device[J]. Catheter Cardiovasc Interv, 2022, 99(5): 1691-1695.
[16]	朱达, 潘家华, 骆志玲, 等. 新一代国产经导管二尖瓣缘对缘修复系统治疗重度二尖瓣反流两例[J]. 中国胸心血管外科临床杂志, 2022, 29(8): 1083-1086. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYX202208021.htm
[17]	Bushari LI, Reeder GS, Eleid MF, et al. Percutaneous transcatheter edge-to-edge MitraClip technique: a practical "step-by-step" 3-dimensional transesophageal echocardiography guide[J]. Mayo Clin Proc, 2019, 94(1): 89-102.
[18]	Ayres NA, Miller-Hance W, Fyfe DA, et al. Indications and guidelines for performance of transesophageal echocardiography in the patient with pediatric acquired or congenital heart disease: report from the task force of the Pediatric Council of the American Society of Echocardiography[J]. J Am Soc Echocardiogr, 2005, 18(1): 91-98.
[19]	Xu WZ, Shou XY, Li JH, et al. Non-fluoroscopic percutaneous transcatheter closure of atrial septal defects in children under transesophageal echocardiographic guidance[J]. World J Pediatr, 2018, 14(4): 378-382. https://link.springer.com/article/10.1007/s12519-018-0179-x
[20]	Konstantinides S, Geibel A, Kasper W, et al. The natural course of atrial septal defect in adults—a still unsettled issue[J]. Klin Wochenschr, 1991, 69: 506-510.
[21]	Ramondo A, Chirillo F, Dan M, et al. Value and limitations of transesophageal echocardiographic monitoring during percutaneous balloon mitral valvotomy[J]. Int J Cardio, 1991, 31(2): 223-233. https://www.sciencedirect.com/science/article/pii/016752739190220J
[22]	Wagdi P, Ritter M. Patient radiation dose during percutaneous interventional closure of interatrial communications[J]. J Cardiol, 2009, 53(3): 368-373. https://www.sciencedirect.com/science/article/pii/S0914508709000409
[23]	欧阳文斌, 潘湘斌, 逄坤静, 等. 单纯食管超声引导经皮封堵治疗房间隔缺损[J]. 中华实用儿科临床杂志, 2014, 29(18): 1425-1427. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXB202304010.htm
[24]	丁智锋, 史学功, 赵韧, 等. 经食管实时三维超声引导继发孔型房间隔缺损封堵的临床疗效研究[J]. 中国循证心血管医学杂志, 2022, 14(6): 700-703. https://www.cnki.com.cn/Article/CJFDTOTAL-PZXX202206014.htm
[25]	张琛, 陈玉龙, 张洁, 等. 经食管超声心动图在室间隔缺损术前的应用价值观察[J]. 中西医结合心脑血管病杂志, 2018, 16(12): 1784-1786. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201812049.htm
[26]	Hahn RT, Abraham T, Adams MS, et al. Guidelines for performing a compre-hensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular An-esthesiologists[J]. J Am Soc Echocardiogr, 2013, 26(9): 921-964.
[27]	Blackshear JL, Odell JA. Appendage obliteration to reduce stroke in cardiac surgical patientswith atrial fibrillation[J]. Ann Thorac Surg, 1996, 61(2): 755-759.
[28]	汤跃跃, 张容亮, 杨寒凝, 等. 经食管实时三维及二维超声心动图在左心耳封堵围术期的应用[J]. 中国医学影像学杂志, 2021, 29(4): 339-342. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYZ202104012.htm
[29]	Sagic D, Otasevic P, Sievert H, et al. Percutaneous implantation of the left ventricular partitioning device for chronic heart failure: a pilot study with 1-year follow-up[J]. Eur J Heart Fail, 2010, 12(6): 600-606.