術内,心内エコーカルディオグラフィーで,左心室小心筋切除と左心室小心筋切除の際に,大動脈下狭窄症の多動性下大動脈狭窄症を診断する
D C Syracuse1, V A Gaudiani, D G Kastl
1Clinic of Surgery and Cardiology Branches, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20014, USA.
Circulation
|September 1, 1978
まとめ
エコーカルディオグラフィーは,手術を受けたイディオパシー性多動性下大動脈狭窄症 (IHSS) の患者で,室間隔膜の厚さを正確に測定しました. 機能が改善されたものの,残留グラデーションは持続しており,手術中の測定はそれを予測できませんでした.
科学分野:
- 心血管外科手術についてです.
- 診断用エコーカルディオグラフィー
- 介入性心臓病学 介入性心臓病学
背景:
- Idiopathic hypertrophic subaortic stenosis (IHSS) は,室間隔膜の厚くなることが特徴である状態である.
- 手術によるミエクトミーは阻害を緩和する治療の選択肢ですが,セプトの厚さの正確な測定は,最適な結果を得るために非常に重要です.
研究 の 目的:
- IHSS.のための左心室内小切除術および小切除術の際の静脈間隔膜の厚さを測定する手術中の心房回響の精度を評価する.
- 残圧グラディエントや機能改善を含む外科的結果とエコーカルディオグラフィの測定を相関させる.
主な方法:
- 15人のIHSS患者で,切除前および切除後の室間隔膜の厚さの測定のために,改造された胸部ノッチの小児超音波トランスデューサを使用しました.
- 切断された筋肉の寸法との相関した術前および術内エコーカルディオグラム測定.
- 6ヶ月の術後フォローアップで患者の機能と圧力グラデーション (休息および誘発可能) を評価した.
主要な成果:
- 術前および手術中のエコーカルディオグラフィー測定は,高い相関性 (r=0.92) を示し,切断された筋肉の寸法 (r=0.98) を正確に予測しました.
- 残りのセプトの平均厚さは,ミエクトミー後の14.3 +/- 0.9mmでした.
- すべての患者は機能的に改善し,休息グラデーションはなかったが,患者の3分の2は残留の誘発性グラデーションを持っていたが,これは手術中の測定で予測できなかった.
結論:
- 術内エコーカルディオグラフィは,IHSS手術中に腸間隔膜の寸法を評価するための信頼性の高いツールです.
- 休息グラデーションの減少と機能の改善に効果的ですが,ミエクトミーは誘発性グラデーションを排除することはできません.
- 一貫した症状および血液動力学的利益を確保するミエクトミー特性を定義するためにさらなる研究が必要です.
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