| Japanese |
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| Title | 僧帽弁形成術において経食道3D心エコーが有用であった症例 |
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| Subtitle | 症例 |
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| Authors | 向井詩保子, 野村実, 杉野芳美, 安中洋美, 尾崎眞 |
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| Organization | 東京女子医科大学医学部麻酔科学教室 |
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| Journal | 循環制御 |
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| Volume | 24 |
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| Number | 3 |
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| Page | 249-252 |
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| Year/Month | 2003/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「緒言」開心術における経食道心エコー(TEE)の有用性は多く報告されているが, とくに僧帽弁形成術で術中TEEによる手術方法の検討や最終診断が行われている. しかし, 従来の2-Dimentional(2D)TEEは客観的に診断するには習熟が必要であり, 詳細な僧帽弁逸脱部位の確定診断ができない症例も経験する. 著者らの施設ではその欠点を補うために術中にほぼリアルタイムに2D TEEから3-Dimentional(3D)TEEを構築するシステムを用い, より客観的な画像のもとに心臓外科医と手術方法を相談している. 今回, 僧帽弁逸脱症の僧帽弁形成術において2Dおよび3D TEEを用いて血圧変動時の逸脱部位の違いがあった症例を経験したので, 手術室内で診断する3D TEEの有用性を報告する. 「症例および方法」37歳男性：僧帽弁逸脱症に伴僧帽弁閉鎖不全症の症例で, 術前の経胸壁心エコーの所見では僧帽弁後尖(P2部分)の逸脱と診断され, 僧帽弁形成術が予定された. 心不全の既往はない. 術前経胸壁心エコーで大動脈弁逆流軽度, 僧帽弁逆流重度, 左室拡張末期径64mm, 左室収縮末期径40mm, 左室内径短縮率38%であった. 今回使用した3D TEEの評価方法システムを示す(図1). |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Three-dimensional transesophageal echocardiography, Mitral valve prolapse |
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| English |
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| Title | The Usefulness of Intraoperative Three-Dimensional Transesophageal Echocardiography(3D TEE)Analysis for Evaluation of Mitral Valve Prolapse. |
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| Authors | Shihoko Mukai, Minoru Nomura, Yoshimi Sugino, Hiromi Yasunaka, Makoto Ozaki |
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| Organization | Tokyo Women's Medical University, Department of Anesthesiology |
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| Journal | Circulation Control |
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| Volume | 24 |
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| Number | 3 |
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| Page | 249-252 |
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| Year/Month | 2003/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Three-dimensional(3D)imaging provides a more comprehensive view of annular stnucture and allows accurate reconstructions of mitral valve anatomy to evaluate the feasibility of intraoperative 3D TEE in patients with mitral valve prolapse(MVP). A 37-year-old man was scheduled to undergo mitral valve plasty due to mitral regurgitation. Pre-operative transthoracic echocardiography showed moderate mitral valve regurgitation with a portion of a posterior leaflet(P2). 2D TEE examination was performed after tracheal intubation, by which 3D TEE mitral valve formation was constructed using 4D surgical view software(Tomtec TM). The location of the prolapse of the mitral valve was assessed with six valve elements(A1, A2, A3, P1, P2, P3：6 points)and the data were examined. 2D TEE findings of MVP localization were in P1, P2. 3D TEE findings were A3, P2 prolapse at blood pressure 80/52 mmHg. And A3, P2, P3 prolapse at blood pressure 100/72 mmHg. Intraoperative 3D TEE evaluation of MVP was possible before initiation of the surgical procedure and feasible. Accurate anatomical finding of MVP is sometimes difficult to understand with use of 2D TEE findings and even with surgical finding after cardiac arrest. 3D data should be of value to the surgeon when performing mitral valve repair. |
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| Practice | Basic medicine |
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| Keywords | Three-dimensional transesophageal echocardiography, Mitral valve prolapse |
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