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KAPALI MİTRAL KOMİSSÜROTOMİ ESNASINDA TRANSÖZOFAJİYAL EKOKARDİYOGRAFİNİN DEĞERİ

The Value of Intraoperative Transesophageal Echocardiography During Closed Mitral Commissurotomy

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2000

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Objective: The procedure of closed mitral commissurotomy under intraoperative transesophageal echocardiography with color flow Doppler imaging is a valuable approach for treating pure, non-calcific mitral stenosis. The aim of this study was to research the value of intraoperative transesophageal echocardiography during closed mitral commissurotomy. Methods and Results: Thirty-nine patients with mitral stenosis underwent closed mitral commissurotomy at our clinic. Eleven patients were male and 28 were female, and the average age was 32.6±7.1 years (range, 18-45 years). Preoperative^, all patients were NYHA class III-IV. There were no valve calcification, left atrial thrombus and severe deformity of subvalvular apparatus. The mean mitral valve orifice area as determined by Doppler pressure half time was 0.8±0.3 cm2 (range, 0.6-1.3 cm2) with a mean transvalvular gradient of 15.7±2.3 mmHg (range, 12-20 mmHg). After commissurotomy, the valvular competence was assessed by transesophageal echocardiography. Intraopera-tive transesophageal echocardiography findings showed a mean mitral valve orifice area of 2.3±1.2 cm2 (range, 2.1-2.8 cm2). None of the patients had significant mitral regurgitation as assessed by color flow Doppler imaging. Conclusion: In appropriate patients, we believe that transesophageal echocardiography gudiance makes closed mitral commissurotomy a safe, useful, and objective procedure.
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Abstract (Original Language): 
Giriş ve Amaç: İntraoperatif transözofajiyal ekokardiyografi eşliğinde kapalı mitral komissürotomi işlemi pür, non-kalsifik mitral stenozu tedavisinde değerli bir yaklaşımdır. Bu çalışmanın amacı, kapalı mitral komissürotomi esnasında transözofajiyal ekokardiyografinin değerini araştırmaktır. Metot ve Bulgular: Kliniğimizde mitral stenozlu 39 olguya kapalı mitral komissürotomi uygulandı. Onbiri erkek 28'i kadın olan olguların ortalama yaşı 32.6±7.1 (dağılımı 18-45 yaş) idi. Preoperatif olarak tüm olgu NYHA class IlI-IV'de idi. Olguların hiçbirinde kapak kalsifikasyonu, sol atriyumda trombüs ve kapak altı apereyinde ciddi deformite yoktu. Doppler ekokardiyografi ile tayin edilen ortalama mitral orifıs alanı 0.8±0.3 cm2 (dağılımı 0.6-1.3 cm2) iken ortalama transvalvüler gradiyent 15.7±2.3 mmHg (dağılımı 12-20 mmHg) idi. Komissürotomi işleminden hemen sonra transözofajiyal ekokardiyografi ile mitral kapağın durumu değerlendirildi. İntraoperatif transözofajiyal ekokardiyografi bulguları olarak, ortalama mitral kapak orifıs alanı 2.3±1.2 cm2 (dağılımı 2.1-2.8 cm2) idi. Renkli Doppler ekokardiyografi ile hiçbir olguda önemli mitral regürjitasyonu saptanmadı. Sonuç: Uygun olgularda, transözofajiyal ekokardiyografi kılavuzluğunda kapalı mitral komissürotomi operasyonunun güvenli, yararlı ve objektif bir işlem olduğuna inanmaktayız.
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  • 1
11-14
  • Turkish

REFERENCES

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