僧帽弁狭窄症における弁病変の程度判定に関する研究 : 超音波心エコー図および心血管造影像と手術所見との対比
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In patients with mitral stenosis, the problem if a mitral commissurotomy is feasible or not is the most important one from the surgical point of view. The purpose of this. study is to estimate the preoperative diagnostic value of echocardiography and angiocardiography in 28 patients with mitral stenosis who underwent mitral commissurotomy. Mobility of the mitral valve leaflets which are estimated by preopevative angiocardiography (ACG) and echocardiography (UCG) are classified into three groups: good, disturbed and highly disturbed. According to this classification, 13 out of 15 patients showed identical results in ACG and UCG. The grade of thickening and fusion of the subvalvular architecture of the mitral valve in ACG and UCG are compared with operative findings. The result were as. follows : 1) In the area of the anterior commissure, 14 out of 15 cases showed the indentical UCG and operative findings. Eleven out of 15 cases showed identical UCG and operative findings in the area of the posterior commissure. In the remaining 4 out of 15 cases, severity of the lesions were underestimated by UCG in comparison with the operative findings. 2) Twelve out of 15 cases showed the identical ACG and operative findings in the area of the anterior commissure, and 11 out of 15 cases showed the same findings in the area of the posterior commissure. In 3 out of 15 cases, severity of the mitral lesion was underestimated by ACG compared to the operative findings. In one case, ACG findings showed more severe lesion than the operative findings. The mitral valve area (MVA) was measured during operation and by UCG before and after the mitral commissurotomy. Close correlation was found between the values of MVA which were measured by UCG preoperatively and values which were directly measured intraoperatively before the mitral commissurotomy. However, there was no relationship between them after the commissurotomy.
- 神戸大学の論文
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