目的 评价经胸二维超声心动图(2DE)、经食道超声心动图(TEE)、经胸三维超声心动图(3DE)在儿童主动脉瓣病变Ozaki手术中的应用价值.方法 回顾性分析7例Ozaki手术患者的2DE、TEE、3DE资料特征.结果 7例患者术前均行2DE及3DE检查, 与手术结果对比, 超声诊断正确7例, 占100％;合并单支冠状动脉2例、冠状动脉肺动脉瘘1例, 超声检查均漏诊.7例均行术中TEE检查, 术后3个月2DE复查, 主动脉反流束宽明显减轻(0.64±0.25)cm vs(0.22±0.04)cm,(P＜0.01)、左心室舒张末期内径明显减小(5.69±0.45)cm vs(4.50±0.83)cm,(P＜0.01).结论2DE、3DE术前可以显示主动脉瓣的数目、大小、狭窄及反流的程度, 比较准确地诊断主动脉瓣病变, 但容易漏诊合并的冠状动脉畸形;TEE在术中即刻效果判断、2DE在术后随访中起重要作用, 是儿童主动脉瓣病变Ozaki手术安全、有效的监测方法.%Objective To evaluate the value of integrated echocardiography in Ozaki operation in children with aortic valve malformation. Methods Ozaki operation was performed in 7 children with aortic valve malformation. Transthoracic 2-dimensional echocardiography (2 DE), Transthoracic 3-dimensional echocardiography (3DE) and transesophageal echocardiography (TEE) were performed before and after Ozaki operation. Results Compared with the surgical findings, aortic valve malformation was diagnosed correctly in 7 cases (100％) by 2 DE and 3DE, 2 cases with single coronary artery and 1 case with fistula between coronary artery and pulmonary artery were miss diagnosed. TEE and 2 DE were performed during and 3 months later of Ozaki operation, vena contracta width of aortic valve regurgitation was reduced significantly (0.64±0.25) cm vs (0.22±0.04) cm, (P＜0.01). Conclusion Integrated echocardiography could clearly demonstrate the number, size of aortic valve anomalies. It was valuable for patients selection before the operation, and evaluating the operative effects and was a safe and effective guidance technique. It was prone to be miss diagnosed for associated coronary artery anomaly.
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