心臟超音波報告解讀：二尖瓣修復手術前後的心臟狀況比較-心臟血管專科

心臟超音波報告解讀？

敬愛的 吳醫師您好：在下因為曾患感染性心內膜炎造成二尖瓣逆流嚴重，於2021年12月初進行了二尖瓣修補手術，以下是手術前二次及手術後二次的心臟超音波報告，想請您幫忙解讀，
1、今年8/25的追綜檢查報告是否樂觀？

2、心臟變大的情形？

3、平常生活上有沒有需注意的事項？

4、可以進行慢跑運動來保養身體嗎？
謝謝您。

一、2021/07/30(手術前)2 BSA: 1.9 m Interpretation Summary Eccentric LVH Aortic root dilatation.39mm Left ventricular systolic function is preserved (cutoff 60% is normal in severe MR) Ruptured mitral valve chordae P2 leaflet.(Hx of prior IE? )？
Mitral regurgitation severe with pulmonary vein reversal. EROA 0.91cm2？
LVESD 36mm ESDi 19mm/m2 No resting pulmonary HTN. consider surgery if LVESD progresses rapidly or over 40mm MMode/2D Measurements ＆ Calculations IVSd: 1.0 cm LVIDd: 6.0 cm FS: 40.2 % LV mass(C)d: 256.4 grams 2 LVIDs: 3.6 cm EDV(Teich): 180.9 ml LV mass(C)dI: 134.6 grams/m LVPWd: 1.0 cm ESV(Teich): 54.2 ml LVIDs Index: 1.9 cm EF(Teich): 70.0 % RWT_: 0.34 2 2 Ao root diam: 3.9 cm LVOT diam: 2.1 cm LVAd ap4: 42.9 cm LVAd ap2: 38.9 cm 2 LVOT area: 3.5 cm LVLd ap4: 9.3 cm LVLd ap2: 8.8 cm EDV(MOD-sp4): 167.0 ml EDV(MOD-sp2): 145.0 ml EDV(sp4-el): 169.0 ml EDV(sp2-el): 145.9 ml 2 2 LVAs ap4: 25.2 cm LVAs ap2: 19.7 cm LVLs ap4: 7.4 cm LVLs ap2: 7.1 cm ESV(MOD-sp4): 70.1 ml ESV(MOD-sp2): 45.9 ml ESV(sp4-el): 72.2 ml ESV(sp2-el): 46.7 ml EF(MOD-sp4): 58.0 % EF(MOD-sp2): 68.3 % EF(sp4-el): 57.3 % EF(sp2-el): 68.0 % SV(MOD-sp4): 96.9 ml SV(sp4-el): 96.8 ml EDV(MOD-bp): 175.5 ml SV(MOD-sp4) Index: 26.7 ml ESV(MOD-bp): 54.9 ml EF(MOD-bp): 68.7 % Doppler Measurements ＆ Calculations MV E max vel: 97.7 cm/sec MV dec time: 0.18 sec Ao V2 max: 119.4 cm/sec LV V1 max PG: 4.3 mmHg MV A max vel: 63.7 cm/sec Ao max PG: 5.7 mmHg LV V1 mean PG: 2.0 mmHg 2 MV E/A: 1.5 AVA(VD): 3.0 cm LV V1 max: 104.1 cm/sec LV V1 mean: 64.6 cm/sec LV V1 VTI: 16.8 cm 2 MR max vel: 240.0 cm/sec MR PISA: 5.7 cm SV(LVOT): 58.5 ml PA V2 max: 79.5 cm/sec 3 MR max PG: 43.3 mmHg SV(LVOT) index: 30.7 ml PA max PG: 2.5 mmHg MR flow rate: 219.1 cm /sec 2 2 MR mean vel: 364.5 cm/sec PA acc slope: 579.2 cm/sec MR ERO: 0.91 cm MR mean PG: 59.5 mmHg PA acc time: 0.13 sec MR volume: 117.2 ml MR VTI: 128.3 cm MR PISA radius: 0.95 cm MR alias vel: 38.5 cm/sec TR max vel: 239.0 cm/sec TR max PG: 23.7 mmHg Page 1 of 2 Left Ventricle Eccentric LVH. Left ventricular systolic function is borderline reduced. Mitral Valve Ruptured mitral valve chordae posterior leaflet. Mitral regurgitation severe. Great Vessel Aortic root dilatation. Mode 2D+ Color.
二、2021/11/1(手術前)2 BSA: 1.9 m Interpretation Summary Eccentric LVH Left ventricular systolic function is preserved Ruptured mitral valve chordae P2 leaflet.(Hx of prior IE )？
Eccentric Mitral regurgitation moderate-severe The LV systolic function is normal The left atrium is borderline dilated. Tricuspid regurgitation mild Pulmonic regurgitation mild MMode/2D Measurements ＆ Calculations IVSd: 0.75 cm LVIDd: 6.4 cm FS: 36.3 % LV mass(C)d: 188.0 grams 2 LVIDs: 4.1 cm EDV(Teich): 209.1 ml LV mass(C)dI: 98.4 grams/m LVPWd: 0.72 cm ESV(Teich): 73.4 ml LVIDs Index: 2.1 cm EF(Teich): 64.9 % RWT_: 0.22 Ao root diam: 3.4 cm ACS: 1.9 cm LA dimension: 4.3 cm Doppler Measurements ＆ Calculations MV E max vel: 103.0 cm/sec MV dec time: 0.19 sec Ao V2 max: 97.0 cm/sec PA V2 max: 55.8 cm/sec MV A max vel: 89.7 cm/sec Ao max PG: 3.8 mmHg PA max PG: 1.2 mmHg MV E/A: 1.1 Ao V2 mean: 62.5 cm/sec PA acc time: 0.20 sec Ao mean PG: 1.9 mmHg Ao V2 VTI: 19.6 cm TR max vel: 165.6 cm/sec TR max PG: 11.0 mmHg Left Ventricle Eccentric LVH. The LV systolic function is normal. No regional wall motion abnormality was noted. Left Atrium The left atrium is borderline dilated. Mitral Valve Ruptured mitral valve chordae posterior leaflet. Mitral regurgitation moderate to severe. Right Heart The right ventricle is normal in size and function. Normal right atrial size. Tricuspid regurgitation mild. Pulmonic regurgitation mild. Page 1 of 2 Great Vessel Aortic root dilatation. PE There is no pericardial effusion. Mode 2D+ Color.
三、2022/10/06(手術後)2 BSA: 1.9 m Interpretation Summary The left ventricle is grossly normal in size and shape. No regional wall motion abnormalities noted. The LV systolic function is normal. s/p Mitral valve repair with artificial chordae and annuloplasty ring Moderate mitral regurgitation. Mild tricuspid regurgitation. MMode/2D Measurements ＆ Calculations IVSd: 0.83 cm LVIDd: 5.1 cm FS: 44.9 % LV mass(C)d: 149.8 grams 2 LVIDd Index(2.2-3.0): 2.6 EDV(Teich): 126.2 ml LV mass(C)dI: 77.1 grams/m LVIDs: 2.8 cm ESV(Teich): 30.5 ml LVIDs Index(1.3-2.1): 1.5 EF(M52%F54%): 75.8 % LVPWd: 0.83 cm RWT_: 0.32 Ao root diam: 4.0 cm asc Aorta Diam: 3.3 cm 2 Ao root area: 12.3 cm ACS: 2.0 cm LA dimension: 4.0 cm Doppler Measurements ＆ Calculations MV V2 max: 159.9 cm/sec Ao V2 max: 92.8 cm/sec LV V1 max PG: 2.5 mmHg PA V2 max: 57.8 cm/sec MV max PG: 10.2 mmHg Ao max PG: 3.4 mmHg LV V1 mean PG: 1.4 mmHg PA max PG: 1.3 mmHg 2 MV V2 mean: 101.8 cm/sec LV V1 max: 79.5 cm/sec PA acc slope: 383.8 cm/sec MV mean PG: 4.7 mmHg LV V1 mean: 54.7 cm/sec PA acc time: 0.15 sec MV V2 VTI: 43.4 cm LV V1 VTI: 16.6 cm TR max vel: 232.3 cm/sec TR max PG: 21.6 mmHg Left Ventricle The left ventricle is grossly normal in size and shape. The LV systolic function is normal. No regional wall motion abnormalities noted. Left Atrium The left atrial size is normal. Right Heart The right ventricle is normal in size and function. Right atrial size is normal. Mitral Valve s/p Mitral valve repair with artificial chordae. An annuloplasty ring is noted in the mitral position. Page 1 of 2 CFM_Doppler There is moderate mitral regurgitation. There is mild tricuspid regurgitation. Mode 2D+ Color.
四、2023/8/25(手術後)2 BSA: 1.9 m Interpretation Summary The left ventricle is borderline dilated. The LV systolic function is normal The left atrium is mildly dilated. Prior mitral valvuloplasty annuloplasty ring Mitral regurgitation moderate Tricuspid regurgitation mild-moderate MMode/2D Measurements ＆ Calculations IVSd: 1.0 cm LVIDd: 5.3 cm FS: 38.6 % LV mass(C)d: 213.6 grams 2 LVIDd Index(2.2-3.0): 2.8 EDV(Teich): 136.3 ml LV mass(C)dI: 112.3 grams/m LVIDs: 3.3 cm ESV(Teich): 42.9 ml LVIDs Index(1.3-2.1): 1.7 EF(M52%F54%): 68.5 % LVPWd: 1.1 cm RWT_: 0.40 Ao root diam: 3.2 cm asc Aorta Diam: 3.1 cm 2 Ao root area: 8.2 cm ACS: 2.1 cm LA dimension: 4.3 cm Doppler Measurements ＆ Calculations MV E max vel: 180.3 cm/sec MV V2 max: 198.2 cm/sec MV dec time: 0.20 sec Ao V2 max: 121.4 cm/sec MV A max vel: 159.1 cm/sec MV max PG: 15.7 mmHg Ao max PG: 5.9 mmHg MV E/A: 1.1 MV V2 mean: 118.8 cm/sec MV mean PG: 6.5 mmHg MV V2 VTI: 49.0 cm LV V1 max PG: 2.8 mmHg PA V2 max: 58.7 cm/sec TR max vel: 260.6 cm/sec LV V1 mean PG: 1.0 mmHg PA max PG: 1.4 mmHg TR max PG: 27.2 mmHg 2 LV V1 max: 83.9 cm/sec PA acc slope: 394.0 cm/sec LV V1 mean: 53.9 cm/sec PA acc time: 0.15 sec LV V1 VTI: 16.5 cm Left Ventricle The left ventricle is borderline dilated. The LV systolic function is normal. No regional wall motion abnormality was noted. Left Atrium The left atrium is mildly dilated. Mitral Valve Prior mitral valvuloplasty annuloplasty ring. Mitral regurgitation moderate. Page 1 of 2 Right Heart Tricuspid regurgitation mild-moderate. Mode 2D+ Color.