Echocardiography can detect cloth cover tears in fully covered Starr-Edwards valves: a long-term clinical and echocardiographic study.
Echocardiography can detect cloth cover tears in fully covered Starr-Edwards valves: a long-term clinical and echocardiographic study.
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超声心动图可以检测完全覆盖的 Starr-Edwards 瓣膜中的布套撕裂：一项长期临床和超声心动图研究。
DOI：
10.1016/s0002-8703(97)70049-8
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发表时间：
1997
影响因子：
4.8
通讯作者：
A. Sagie
中科院分区：
文献类型：
--
作者：
Y. Shapira;M. Feinberg;R. Hirsch;M. Nili;A. Sagie
通过尸检或重复手术评估，全覆盖Starr-Edwards瓣膜的布覆盖撕裂发生率约为1%/患者年。然而，没有超声心动图研究探讨了这一现象。本研究设计为一次性观察性研究，旨在探索二维经胸超声心动图识别35例晚期存活者（38枚完全覆盖的Starr-Edwards瓣膜，20 - 24年前手术）布覆盖撕裂的能力。还研究了这一高度选择的晚期存活者组的血流动力学特征、临床状态和瓣膜相关并发症。5例患者还接受了经食管超声心动图检查。附着在人工瓣膜笼上并漂浮在下游的细长回声团块被认为是布撕裂的指示。16例患者植入主动脉瓣假体，16例植入二尖瓣假体，3例植入双假体瓣膜。在6名（17.1%）患者中（4名植入主动脉瓣假体，2名植入二尖瓣假体），检测到提示布盖撕裂的回声肿块，这在3名患者中得到了经食道超声心动图的证实。2例患者的超声心动图检查结果在手术中得到证实。这6例患者的最初表现为心内膜炎、可能的栓塞、不明原因的呼吸困难和虚弱，各1例。两名患者无症状。任何患者均无明显人工瓣膜故障的证据。有和无布覆盖撕裂的患者的跨瓣压差相似。超声心动图结果高度提示布覆盖层撕裂并不罕见，并且可以在完全覆盖的Starr-Edwards瓣膜患者的术后第三个十年检测到。有必要进行一项前瞻性研究，以评价在使用这些瓣膜型号的无症状患者中偶然超声心动图发现提示布罩撕裂的临床意义。(Am Heart J 1997;134：665-71.）
The incidence of cloth cover tears in fully covered Starr-Edwards valves, as assessed by autopsy or repeat surgery, is approximately 1% per patient-year. However, no echocardiographic study has explored this phenomenon. This study was designed as a one-time observational study and aimed to explore the ability of two-dimensional transthoracic echocardiography to identify cloth cover tears in 35 late survivors with 38 fully covered Starr-Edwards valves who had been operated on 20 to 24 years earlier. The hemodynamic profile, clinical status, and valve-related complications in this highly selected group of late survivors were also studied. Five patients also underwent transesophageal echocardiography. An elongated echogenic mass attached to the prosthetic valve cage and floating downstream was considered indicative of cloth tear. There were 16 patients with aortic valve prostheses, 16 with mitral valve prostheses, and three with double prosthetic valves. In six (17.1%) patients (four with aortic valve prostheses, two with mitral valve prostheses), an echogenic mass suggestive of cloth cover tear was detected, which was confirmed by transesophageal echocardiography in three patients. In two patients the echocardiographic finding was confirmed at surgery. The initial presentation of these six patients was endocarditis, possible embolism, unexplained dyspnea, and weakness in one patient each. Two patients were asymptomatic. There was no evidence of significant prosthetic valve malfunction in any patient. The transvalvular gradients were similar in patients with and without cloth cover tears. Echocardiographic findings highly suggestive of cloth cover tears are not uncommon and can be detected in the third postoperative decade in patients with fully covered Starr-Edwards valves. A prospective study to evaluate the clinical significance of an incidental echocardiographic finding suggestive of cloth cover tears in asymptomatic patients with these valve models is warranted. (Am Heart J 1997;134:665-71.)
环孢菌素免疫抑制男性对原位移植人心脏动态运动的反应。
DOI：
10.1016/0002-9149(89)90547-x
发表时间：
1989
期刊：
The American journal of cardiology
影响因子：
--
作者：
Nixon,JV;Rosenburg,H;Romhilt,D;Thompson,JA;Hastillo,A;Hess,ML
通讯作者：
Hess,ML