在一个左心室辅助装置植入术中采用实时三维经食管超声.PDFVIP

文献进展摘要及翻译 贵州医科大学麻醉学系研究生（心电生理及记忆课题组） 文献名：（中文）在一个左心室辅助装置植入术中采用实时三维 经食管超声心动图来识别重度二尖瓣狭窄,采用三维经胸超 声心动图来评估二尖瓣狭窄程度 （英文）Three-Dimensional Transthoracic Echocardiography for Evaluation of Mitral Stenosis Identification of Severe Mitral Stenosis Using Real-Time Three-Dimensional Transesophageal Echocardiography During an Left Ventricular Assist Device Insertion 译 者：王子君 PATIENT CONSENT STATEMENT Patient consent was obtained, for publication of a case report with images. CASE We present a 78-year-old woman with progressive nonischemic cardiomyopathy and a history of rheumatic mitral stenosis (MS) with a baseline cardiac index of 1.5 L/min/m2 who underwent destination left ventricular assist device (LVAD) insertion. The patient had balloon valvuloplasty of the mitral valve 20 years before presentation and had been followed for moderate MS, with a mean transmitral gradient of 9 mm Hg measured by transthoracic echocardiography (TTE) 6 weeks before surgery. On intraoperative 2D transesophageal echocardiography (TEE), she had severely depressed left ventricular systolic function, mild right ventricular dysfunction, severe biatrial enlargement, and moderate mitral regurgitation with Carpentier class IIIa leaflet restriction (Supplemental Digital Content 1, Supplemental Video, http://links.lww. com/AA/B496). The patient also had moderate tricuspid regurgitation, trace pulmonic regurgitation, and no aortic regurgitation. She was pacemaker-dependent with a ventricular pacing at a rate of 80 bpm. Intraoperatively, the patient had a mean transmitral diastolic gradient of 7 mm Hg and a peak gradient of 13 mmHg (Figure 1). The pressure half-time (PHT) was averaged across several beats to be 150 milliseconds, which correlates with a mitral