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IntraoperativeTransesophagealEchocardiographicPredict术中经食管超声心动图的预测会计学Aim of the study第1页/共13页The present study examines the intraoperative echocardiographic features associated with late failure of aortic valve repair.Method: Study population第2页/共13页From 12/1995 to 06/2007186 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 ARCompared for immediate post-operative TEE measurements.Analysis of the cause of recurrence (group B C).第3页/共13页Method: TEE analysis Pre-operative and immediate postoperative TEE : AnnulusSinusesST junction Tubular aorta120 degree -LAX Height of the sinuses Coaptation lengthSymmetry of the coaptation Tips to annulus Cusp’s belly to annulus Eccentric Jet Vena contracta wideResults (1): Follow-up:第4页/共13页Mean Follow-up : 24 months41 pts had recurrent severe AR23 needed a REDOF-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 Results (2): Pre-operative characteristics第5页/共13页Before surgeryGroup A (n=112)Group B (n=23)Group C(n=41)P value Bicuspid (%)40 1737 0.12Marfan (%)0 915 0.001Restrictive AR (%)134346 0.001Annulus (mm)25 ± 424 ± 426 ± 60.27Sinus (mm)40 ± 839 ± 941 ± 130.61ST jct° (mm)35 ± 935 ± 934 ± 90.93Tubular Ao (mm)42 ± 11 39 ± 837 ± 130.14Results (3): immediate post-op TEE:第6页/共13页After surgeryGroup A (n=112)Group B (n=23)Group C(n=41)P value Coapt. Length (mm)6.6 ± 2.8 3.2 ± 1.4 2.2 ± 1.6 0.001Tips - annulus (mm)6.9 ± 4.3 3.0 ± 3.1 0.1 ± 4.2 0.001Cusp - annulus (mm)-1.2 ± 2.8 -1.5 ± 3.2 - 3.9 ± 4.8 0.001Vena contracta (mm)0.1 ± 1.12.4 ± 1.72.6 ± 1.40.001Eccentric Jet (%)930730.001Annulus (mm)21 ± 421 ± 426 ± 40.001Sinus (mm)29 ± 530 ± 531 ± 50.04ST jct°
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