Real-Time Three-Dimensional Transesophageal Echocardiography in the Intraoperative Assessment of Mitral Valve Disease
Real-Time Three-Dimensional Transesophageal Echocardiography in the Intraoperative Assessment of Mitral Valve Disease
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DOI：
10.1016/j.echo.2008.11.008
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发表时间：
2009-01-01
影响因子：
6.5
通讯作者：
Miller, Fletcher A.
中科院分区：
文献类型：
--
作者：
Grewal, Jasmine;Mankad, Sunil;Miller, Fletcher A.
背景：本研究的目的是评价实时三维(3D)经食道超声心动图对术中二尖瓣病变评估的可行性，并与二维(2D)超声心动图进行比较。方法：前瞻性研究42例二尖瓣返流(MR)行二尖瓣修补术的患者。术中2D和3D经食道超声心动图(TEE)检查使用最近推出的TEE探头，提供实时3D成像。超声心动图专家对2D TEE检查结果视而不见，在3D经食道超声心动图上评估MR的病因。同样，对3D TEE检查结果失明的专家评估2D TEE检查结果。结果：在手术检查时，12%的患者发现了缺血性MR，31%的患者发现了复杂的双叶粘液瘤，55%的患者发现了特殊的扇贝病变。三维TEE图像采集在短时间内(60+/-18秒)完成，所有患者均可行，大多数患者的图像质量最佳(36%)或良好(33%)。结论：实时三维经食道超声心动图是一种在复杂疾病背景下识别特定病变的可行方法，可迅速用于评价接受机械瓣膜修补术的患者。(J Am Soc超声心动图2009；22：34-41。)
Background: The aims of this study were to evaluate the feasibility of real-time 3-dimensional (3D) transesophageal echocardiography in the intraoperative assessment of mitral valve (MV) pathology and to compare this novel technique with 2-dimensional (2D) transesophageal echocardiography.Methods: Forty-two consecutive patients undergoing MV repair for mitral regurgitation (MR) were studied prospectively. Intraoperative 2D and 3D transesophageal echocardiographic (TEE) examinations were performed using a recently introduced TEE probe that provides real-time 3D imaging. Expert echocardiographers blinded to 2D TEE findings assessed the etiology of MR on 3D transesophageal echocardiography. Similarly, experts blinded to 3D TEE findings assessed 2D TEE findings. Both were compared with the anatomic findings reported by the surgeon.Results: At the time of surgical inspection, ischemic MR was identified in 12% of patients, complex bileaflet myxomatous disease in 31%, and specific scallop disease in 55%. Three-dimensional TEE image acquisition was performed in a short period of time (60 +/- 18 seconds) and was feasible in all patients, with optimal (36%) or good (33%) imaging quality in the majority of cases. Three-dimensional TEE imaging was superior to 2D TEE imaging in the diagnosis of P1, A2, A3, and bileaflet disease (P < .05).Conclusions: Real-time 3D transesophageal echocardiography is a feasible method for identifying specific MV pathology in the setting of complex disease and can be expeditiously used in the intraoperative evaluation of patients undergoing MV repair. (J Am Soc Echocardiogr 2009; 22: 34-41.)