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JACC:经食道心超在结构性心脏病介入手术中的安全性研究

2020-06-26 MedSci原创 MedSci原创

尽管经食道超声心动图(TEE)广泛应用于指导心脏结构性干预,但在这方面的安全性评估研究尚缺乏。本研究旨在评估心脏结构性干预中TEE操作后食管或胃损伤的发生率、并发症类型和相关因素。

尽管经食道超声心动图(TEE)广泛应用于指导心脏结构性干预,但在这方面的安全性评估研究尚缺乏。本研究旨在评估心脏结构性干预中TEE操作后食管或胃损伤的发生率、并发症类型和相关因素。

本研究是一项前瞻性研究,包括50名接受结构性心脏介入治疗的患者,其中TEE在指导手术中发挥了中心作用。术前和术后立即进行食管胃十二指肠镜检查(EGD),寻找干预过程中可能出现的新损伤。根据损伤类型分为2组:复杂损伤(壁内血肿、粘膜撕裂)和轻微损伤(瘀点、瘀斑)。术后EGD显示86%(n=43/50)的患者出现新的损伤,复杂病变占40%(n=20/50)。复杂病变患者更常出现基线EGD异常(70%对37%;p=0.04),术后吞咽困难或吞咽困难发生率更高(40%对10%;p=0.02)。与复杂病变风险增加相关的独立因素是TEE操作下较长的操作时间和较差或次优的图像质量。

研究结果显示,大多数接受结构性心脏介入治疗的患者表现出与经食道心超相关的某种形式的损伤,较长的手术时间和较差或不理想的图像质量决定了风险的增加。

原始出处:

Afonso B et al.Safety of Transesophageal Echocardiography to Guide Structural Cardiac Interventions.JACC.2020 June.

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    2021-05-07 hbwxf
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