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目的 评价心脏瓣膜置换术后瓣周漏的电子束CT(EBCT)表现。方法 对121例心脏瓣膜置换术后的患者施行EBCT扫描(连续容积或单层序列横断面扫描),男93例,女28例,年龄16~74岁。其中102例患者行主动脉瓣置换术, 12例患者行二尖瓣置换术, 7例患者行主动脉瓣和二尖瓣双瓣置换术。结果 心脏瓣膜置换术后EBCT扫描显示,主动脉瓣周点线状对比剂外溢7例,瓣缘连续线状对比剂外溢3例,大量对比剂外溢4例。二尖瓣周点线状对比剂外溢1例(该患者同时伴有主动脉瓣周大量对比剂外溢)。EBCT扫描瓣膜置换术后瓣周漏阳性率为11. 57%(14 /121)。结论 EBCT可作为瓣膜置换术后瓣周漏患者随访及再次手术治疗前的常规检查。
Objective To evaluate the echocardiographic (EBCT) performance of valvular leak after heart valve replacement. Methods One hundred and twelve patients undergoing heart valve replacement were enrolled in this study. EBCT (continuous volume or single-layer sequence cross-sectional scan) was performed in 93 patients, 28 females, aged 16-74 years. Among them, 102 patients underwent aortic valve replacement, 12 patients underwent mitral valve replacement, and 7 patients underwent aortic valve replacement and mitral valve replacement. Results EBCT after aortic valve replacement showed that there were 7 cases of linear contrast agent overflow in aortic valve circumference, 3 cases of continuous linear contrast agent overflow in valve margin and 4 cases of massive contrast leakage. A case of mitral valve linear contaminant spill week (this patient accompanied by aortic valve a lot of contrast agent spillover). The positive rate of paravalvular leaks after EBCT scans was 11. 57% (14/121). Conclusion EBCT can be used as a routine examination of patients with valvular leak after valve replacement and before reoperation.