Applied research on multiplane transesophageal echocardiography standardized measurement used in the modified morrow procedure
10.3969/j.issn.1009-0754.2015.06.022
- VernacularTitle:经食管超声心动图标准化测量在改良 Morrow术中的应用研究
- Author:
Xin LI
1
;
Chuzhong TANG
;
Han LI
Author Information
1. 海军总医院超声医学科
- Keywords:
Transesophageal echocardiography;
Hypertrophic cardiomyopathy;
Interventricular septum;
Left ventricular outflow tract
- From:
Journal of Navy Medicine
2015;(6):538-540
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application value of transesophageal echoeardiography ( TEE) standardized measure-ment used in the modified morrow procedure .Methods From March, 2008 to December, 2013, the modified Morrow procedure was performed in 21 cases of hypertrophic cardiomyopathy (HCM) confirmed with transthoracic echocardiography (TTE).Before establish-ment of extracorporeal circulation , TEE assessments of the left ventricular outflow tract ( LVOT) pressure gradient and interventricular septum thickness ( IVST) were used to correct the transthoracic echocardiography ( TTE) measurements and the distance between ante-rior mitral valve leaflet columnae papillae and the aortic valve ring to detect the excision range .Mitral valve ring diameter , leaflet echo intensity and the extent of leaflets regurgitation were applied to determine whether valve replacement was required .TEE was repeated upon completion of myocardial resection to compare postoperative measurements with preoperative ones to assess the curative effect .Half ayearlater,allthepatientshadTTEfollow-up.Results (1)PreoperativeTEEmeasurementsofLVOTpressuregradientandIVST were (87.6 ±3.1) mmHg and (22.1 ±0.5) mm respectively.TEE measurements of LVOT and IVST pressure gradient the instant af-ter operation were (18.4 ±2.5) mmHg and (11.5 ±0.4) mm respectively.There was significant reduction of them , as compared with those before operation(P<0.05).(2) TEE detection predicted that mitral valve replacement was required in 5 cases, of which 4 cases underwent mitral valve replacement .TEE detection also showed that there was no significant mitral valve regurgitation after surgery . (3) All the patients had medical follow-ups, and results indicated that 19 patients had no LVOT obstruction recurrence .Conclusion TEE standardized measurement could precisely determine the scope of excision , predict whether or not valve replacement was required ,and help to evaluate the surgical effect the moment after surgery , which was of importance value clinically .
