Objective To evaluation the diagnostic value of echocardiography in mechanical prosthesis valve dysfunction(MPVD).Methods Fifty-two patients who underwent reoperation due to MPVD were included,and the preoperative,introperative and postoperative results of echocardiography was compared with the results of surgery or pathologic diagnosis.Results The etiology of MPVD based on cardiac surgery was thrombus in 12,fibrous tissue hyperplasia in 23,thrombus and fibrous tissue hyperplasia in 16,lost of mechanical disc in 1.The types of MPVD diagnosed by echocardiography were stenosis in 29,regurgitation in 2,stenosis and regrigitation in 12,intermittent obstruction in 8,and total obstruction in 1.Successful assessment of prosthetic disc by transthoracic echocardiography was 78.4％ and can be improved to 96.1 ％ when combined with transesophageal echocardiography.Complementary message by transesophageal echocardiography were provided in 10 patients and corrective message in 1 patient.No recurrent MPVD was find during the follow-up.Conclusions Echocardiography can be used as the frist choice for the evaluation of the MPVD and can make precise assessment of the abnormal hemodynamic change and state of motion of the valve.

Objective: To evaluate the intro-operative transesophageal echocardiography (TEE) for extended septal myectomy in patients with obstructive hypertrophic cardiomyophathy (HCM).
Methods: A total of 56 obstructive HCM patients with extended septal myectomy in our hospital from 2012-01 to 2012-12 were retrospectively studied. The results of pre-operative transthoracic echocardiography, intro-operative TEE and post-operative transthoracic echocardiography were analyzed and compared.
Results: There were 36 male and 20 female patients with the average age of (46.1 ± 11.3) years. The pre-operative width of inter ventricular septal was (26.1 ± 6.9) mm, left ventricular outlfow tract (LVOT) pressure gradient was (87.5 ± 12.5) mmHg. All patients received successful operation, no in-hospital death, no TEE related complication. The removed ventricular septal thickness was at (10.7 ± 2.1) mm, length at (39.1±5.5) mm. Compared with pre-operative transthoracic echocardiography, TEE indicated the immediate drop of post-operative LVOT peak velocity (4.57 ± 0.99)m/s vs (1.68±0.46)m/s and LVOT peak gradient (87.5 ± 34.4) vs (11.3 ± 7.0) mmHg, both P<0.001;signiifcant reduce of mitral regurgitation (MR) and mitral valve systotic onterior motion, both P<0.001. TEE showed that intra-operative LVOT peak velocity (r=0.63) and LVOT peak gradient (r=0.48) well related to post-operative transthoracic echocardiography. Post-operative TEE found that 2 patients had ventricular septal defect and 1 received surgical repair.
Conclusion: TEE is safe for extended septal myectomy in obstructive HCM patients. It may pre-operatively identify the cause and degree of MR, evaluate the post-operative improvement of LVOT obstruction and MR. Meanwhile, TEE may ifnd the surgical complication for in time correction in relevant patients.