Intermittently stuck valve after mitral valve replacement diagnosis by echocardiography: a case report
-
摘要: 本例患者二尖瓣机械瓣置换术后6年出现间歇性心悸, 术前经胸超声心动图(TTE)提示二尖瓣机械瓣卡瓣, 拟行瓣膜再次置换手术。术前麻醉后TTE实时三维经食管超声心动图(3D-TEE)提示存在不稳定性卡瓣, 原因为瓣环周围血管翳形成过长, 故更换手术方式, 未对二尖瓣机械瓣进行再次置换, 仅清除机械瓣周围血管翳。术后随访6个月, 患者心功能状态恢复良好, 生活质量明显改善。Abstract: The patient had the symptom as intermittent palpitations after the surgery of mechanical mitral valve replacement for six years later.Transthoracic echocardiography (TTE) indicated that mechanical mitral valve was stuck.Second valve replacement surgery was planned for treating with mitral valve.Preoperative anesthetized TTE and real-time three-dimensional transesophageal echocardiography (3D-TEE) indicated the presence of an unstable stuck valve, with the instability caused by excessive pannus formation around the annulus.Finally, we choosed to clean the surrounding pannus rather than replace the mechanical mitral valve again.Follow up in 6 months, the cardiac function recovered well, and the quality of life improved significantly.
-
Key words:
- pannus /
- stuck valve /
- echocardiography
-
-
图 2 患者术前麻醉后检查图像
Figure 2. Pre-operative anesthetized examination images of the patient
-
[1] 吴巧燕, 杨泉林, 王春生, 等. 经胸超声心动图评估人工机械主动脉瓣血管翳清除术及再次置换术的安全性及有效性[J]. 中国临床医学, 2022, 8(5): 753-759. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX202205026.htm
[2] 魏士雄, 姜胜利, 张林, 等. 单纯主动脉机械瓣血管翳清除术的短期临床效果[J]. 中华胸心血管外科杂志, 2020, 36(1): 31-34.
[3] Park B, Sung K, Park PW. Clinical implication of transaortic mitral Pannus removal during repeat cardiac surgery for patients with mechanical mitral valve[J]. Circ J, 2018, 82(2): 396-402. doi: 10.1253/circj.CJ-17-0463
[4] 张梅, 徐铭俊. 心瓣膜疾病介入术中的慧眼: 超声心动图的应用[J]. 临床心血管病杂志, 2018, 34(12): 1145-1149. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2018.12.001
[5] 郭影, 钟小芳, 林小璇, 等. 经食管超声心动图在心脏介入手术中的临床应用价值[J]. 临床心血管病杂志, 2023, 39(8): 585-590. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2023.08.004
[6] Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines[J]. Circulation, 2017, 135(25): e1159-e1195.
[7] 赵银花, 杨丽, 王蕴晗, 等. 人工瓣膜置换术后再次手术患者的超声心动图研究[J]. 实用临床医药杂志, 2022, 8(16): 96-100. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202216020.htm
-
下载:
图(4)
计量
- 文章访问数: 248
- PDF下载数: 11
- 施引文献: 0