Mitral Valve Surgery - Surgery Series, 2/2/21
25:25-27:03
This is a transesophageal echo and this is a different type of four chamber view but what you're seeing here is the left ventricle. What you're seeing here is the left atrium. This is the anterior leaflet and the posterior leaflet and there you can see here. This is probably a better way to image the posterior leaflet you can see that excursion of the leaflet backwards into the left atrium
この画像は経食道心エコーの四腔像です。ここが左心室、こちらが左心房、これが前尖、後尖です。この画像では、左心房側に後尖が逸脱しているのがよく見えると思います。
The next view is a comparison view, same view. This four chamber but this is with doppler flow and you can see that this, this tendency to prolapse. It does not allow for the coaptation that Dr. Cameron described and so it allows for blood to go in the normal direction but then it allows for this blood, this big torrent of blood, to flow, this big bright flame, to flow in the backward direction.
次のスライドは同じ四腔像ですが、比較のためにドプラー法の画像も並べました。逸脱の様子が分かると思います。Duke先生が先ほど説明されましたが、弁はきちんと閉じていません。血液は正常な方向に流れているものの、大きな炎のような逆流がみられます。
Finally one really good image. This is a long axis view on a transesophageal echo and this actually is a great example. Here, here's the anterior leaflet. Here's the posterior leaflet and you can see this is the P2 prolapse, P2 partial flail so you can actually see this debris, kind of flinging around on the end of this leaflet and that is a a chordae, that's ruptured that's literally just being dragged around as the leaflet opens and closes but that is a P2 partial frail leaflet there and that obviously is part of the mechanism of this, this regurgitation. You can see how diffuse the regurgitation here is very, very eccentric in a lot of directions.
最後は長軸像ですが、非常に上手く撮影できた画像です。ここが前尖、こちらが後尖で、P2逸脱の画像です。後尖の先に切れ端のようなものが見えると思いますが、これが断裂した腱索で、弁が開閉する度にブラブラしています。このP2逸脱がこの逆流の原因の一部であることは明らかで、あらゆる方向に逆流がみられますので、かなりの異常所見です。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
