Intraoperative Transesophageal Echocardiographic Predict：术中经食管超声心动图的预测.pptVIP

Intraoperative Transesophageal Echocardiographic Predictors of Recurrent Aortic Regurgitation after Aortic Valve Repair Aim of the study The present study examines the intraoperative echocardiographic features associated with late failure of aortic valve repair. Method: Study population From 12/1995 to 06/2007 186 consecutive patients (51 women, mean age: 54-Yrs) - Aortic valve repair for significant AR - With comprehensive pre-, intra- and follow-up echocardiography 122 pts (group A, 53- Yrs) with no AR 23 pts (group B, 50- Yrs) with grade 1 AR 41 pts (group C, 63- Yrs) with recurrent severe AR Compared for immediate post-operative TEE measurements. Analysis of the cause of recurrence (group B C). Method: TEE analysis Results (1): Follow-up: Results (2): Pre-operative characteristics Results (3): immediate post-op TEE: Results (4): Cox univariate analysis Results (4): Cox multivariate analysis TEE decision chart 4-years Survival free from redo according to TEE Conclusion: Our results demonstrate that intraoperative TEE can be used to identify pts undergoing AR repair who are at increased risk for late repair failure * * le Polain JB, Pouleur AC, Vancraeynest D, Pasquet A, Gerber B, Vandijck M, Noirhomme P, El Khoury G, Vanoverschelde JL Cliniques Universitaires Saint Luc, Brussels, Belgium Université Catholique de Louvain Pre-operative and immediate postoperative TEE : 120 degree -LAX Annulus Sinuses ST junction Tubular aorta Height of the sinuses Coaptation length Symmetry of the coaptation Tips to annulus Cusp’s belly to annulus Eccentric Jet Vena contracta wide Mean Follow-up : 24 months 41 pts had recurrent severe AR 23 needed a REDO F-up TEE identified the cause of repair failure as Cusp prolapse: 26 pts Restrictive cusp motion: 9 pts Rupture of a pericardial patch : 3 pts Aortic dissection : 2 pts Endocarditis : 1 pt 39 ± 8 35 ± 9 39 ± 9 24 ± 4 43 9 17 Group B (n=23) 0.14 37 ± 13 42 ± 11 Tubu