Læknablaðið - 15.02.1989, Blaðsíða 34

70
LÆKNABLAÐIÐ
undir míturlokurof (commissurotomy) (10).
Ennfremur hafa aðrir bent á verulega ónákvæmni
og skekkjur við notkun tvívíddar hjartaómunar
aðferðarinnar, er torveldar kliníska notkun
hennar við ákvörðun míturlokuflatarmáls (18).
Nú orðið er algengt að míturlokuþrengsli séu
metin einvörðungu óblóðugt með Doppler tækni
og hjartaþræðingu sleppt. Undantekning eru þau
tilfelli þar sem þörf er viðbótarupplýsinga, til
dæmis kransæðamyndatöku hjá eldri sjúklingum
(19). Hjá yngri sjúklingum nægir yfirleitt mat
með Doppler til að ákveða hvort lokuaðgerðar sé
þörf. Þegar til viðbótar Doppler rannsókn koma
þær upplýsingar er tvívíddar hjartaómun getur
gefið um útlit og ástand míturlokunnar, er einnig
hægt að ákveða hvaða tegund aðgerðar skuli beitt
með fullkomlega óblóðugri forrannsókn (13, 20).
SUMMARY
Doppler ultrasound was performed in 20 (10 men)
patients with suspected rheumatic mitral valve stenosis
within 48 hours prior to cardiac catheterization. Their
age ranged from 48 to 70 (mean ±SD, 60 ±6) years.
Atrial fibrillation was present in 12 patients, 8 had sinus
rythm. Mean diastolic Doppler and catheterization
gradients over the mitral valve correlated closely (r =
0.85). Mitral valve areas assessed by the two methods
were also in good aggreement (r = 0.93). Although
compared to catheterization the Doppler technique
tended to underestimate both the mean gradient and the
mitral valve area, this small methodological difference is
of no clinical importance. Doppler ultrasound is as
reliable a method as cardiac catheterization to assess
mitral valve stenosis and to determine the need for valve
surgery.
HEIMILDIR
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