胸腔大动脉测量使用手术内经食道心声:通过心脏磁共振验证
Lisa Q Rong1, Sena Chun1, Pablo Villar-Calle2
1Department of Anesthesiology, Weill Cornell Medicine, New York, NY.
Journal of cardiothoracic and vascular anesthesia
|February 18, 2025
概括
术内透食管心声谱 (TEE) 在患有上升性大动脉动脉瘤的患者中准确测量大动脉直径,与心脏磁共振成像 (CMR) 显示强烈一致. 这些发现支持TEE指导大动脉动脉瘤修复手术决策.
科学领域:
- 心血管成像 - 心血管成像
- 大动脉动脉瘤研究研究
- 手术决策支持手术决策支持
背景情况:
- 上升性大动脉动脉瘤需要精确的直径测量来进行手术规划.
- 心脏磁共振成像 (CMR) 是大动脉评估的标准.
- 在外科手术期间的成像模式需要验证,以提供外科手术期间的指导.
研究的目的:
- 为了评估手术内转食管心声学 (TEE) 和手术前心磁共振成像 (CMR) 之间对大动脉直径测量的一致性.
- 评估TEE在指导上升大动脉动脉瘤的术后决策中的实用性.
主要方法:
- 对30名患者进行前性研究,这些患者正在使用假体移植进行上升性大动脉修复.
- 在手术期间的TEE (2D和3D) 测量与手术前的Cine-CMR和3D磁共振血管学进行了比较.
- 统计分析包括相关性和布兰德-阿尔特曼方法.
主要成果:
- 测量TEE显示了与CMR在所有大动脉段 (根,上升,门,下降) 的显著相关性.
- 观察到非常好的相关系数 (r = 0.880.98) 和p < 0.001.
- 布兰德-阿尔特曼分析揭示了小的平均差异 (0.040.22厘米) 和狭窄的协议边界,TEE稍微低估了直径.
结论:
- 术内TEE是一种可行且准确的方法,用于测量上升性大动脉动脉瘤中的大动脉直径.
- 与CMR达成高度一致,支持使用手术内TEE进行外科决策.
- TEE可以可靠地指导大动脉置换手术.
相关概念视频
01:30Equipments Used To Measure Blood Pressure
Direct Method
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:23Assessment of blood pressure in brachial artery(two-step method)
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
01:19Assessing Blood pressure using a doppler ultrasound
To obtain accurate blood pressure measurements in clinical settings, especially when traditional methods are insufficient, healthcare professionals utilize the Doppler ultrasound technique. This method uses high-frequency sound waves to detect blood flow within the arteries, which is crucial for patients with conditions that complicate circulatory system assessment.
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:27Assessment of the Cardiovascular System III: Palpation
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...
01:25Assessment of the Cardiovascular System IV: Auscultation
Cardiac auscultation is a clinical skill used to assess heart function and detect abnormalities. It involves listening to heart sounds at specific anatomical locations through a stethoscope.
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.