Fifty patients with rheumatic mitral stenosis aged twelve to thirty-six (twenty +/- six) years were studied by two-dimensional, pulsed and color Doppler echocardiography during, seventy-two hours after, and biweekly for three months after balloon mitral valvuloplasty (BMV). Transesophageal echocardiography (TEE) done immediately after BMV (in the catheterization laboratory) detected a new atrial septal defect (ASD) in 46 (92%) patients. These measured 1 to 2 (mean 1.2 +/- 0.3) mm in diameter. Doppler color flow mapping guided the location of the ASD in most of the cases. A narrow jet of left-to-right shunt could be evaluated by pulsed Doppler studies. Velocity time integral (VTI) of the jet across one cardiac cycle and the diameter of the ASD were used to calculate the left-to-right shunt (shunt = VTI x pi (D/2)2 x heart rate). The estimated shunt was 0.04-0.39 (mean 0.20 +/- 0.10) L/minute. A repeat study at seventy-two hours revealed the defect in 40 (80%) patients. At three months, the defect persisted in only 5 (10%) cases. The mean interval of closure of ASD was 4.6 +/- 2.2 weeks. The authors conclude(1) ASD occurs commonly after BMV, (2) the septal defect and the resultant left-to-right shunt are insignificant, and (3) ASD disappears in the majority of cases by three months after BMV.

译文

通过二维,脉冲和彩色多普勒超声心动图对50例12至36岁 (二尖瓣狭窄) 的二尖瓣狭窄患者进行了研究。球囊二尖瓣成形术 (BMV)。BMV (在导管实验室) 后立即进行经食管超声心动图 (TEE) 在46 (92%) 例患者中发现了新的房间隔缺损 (ASD)。这些测量的直径为1至2 (平均1.2 +/- 0.3) mm。在大多数情况下,多普勒彩色血流图可指导ASD的位置。可以通过脉冲多普勒研究来评估从左向右分流的窄射流。在一个心动周期内射流的速度时间积分 (VTI) 和ASD的直径用于计算从左向右分流 (分流 = VTI x pi (D/2)2 x心率)。估计分流为0.04-0.39 (平均0.20 +/- 0.10) L/分钟。72小时的重复研究揭示了40 (80%) 名患者的缺陷。在三个月时,缺陷仅在5 (10%) 例中持续存在。ASD的平均闭合间隔为4.6 +/- 2.2周。作者得出的结论是 :( 1) BMV后ASD通常发生; (2) 间隔缺损和由此产生的左右分流无关紧要; (3) 在BMV后三个月内,大多数情况下ASD消失。

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