The Application Value Of Echocardiography In Diagnosis And Treatment For Sinus Of Valsalvaaneurysm And Combined With Ventricalar Septal Defect

Objective To analyze and evaluate the diagnostic and treatment valve of transthoracic echocardiography(TTE)in sinus of valsalva aneurysm(SVA)and combined with ventricular septal defect(VSD),and assess the changes of postoperative cardiac morphology and function.Materials and methods The clinical data of 68 patients with SVA diagnosed by TTE in the first affiliated hospital of guangxi medical university between June 2012 and November 2018 were selected and retrospectively analyzed.All patients were confirmed through cardiac surgery,and the preoperative and postoperative TTE date for all of them were integrated.(1)The related measurements of TTE examination for all cases before and after surgery were collected,including the diameter of each cardiac cavity,cardiac function of left ventricular,regurgitation of each cardiac valve.The following characteristics of SVA were observed,including its origin location,morphology,diameter,whether it ruptured and which heart chamber it ruptured into,the number anddiameter of its crevasse,and the blood flow doppler ultrasound of it.To find out whether it combined with VSD or other cardiovascular malformations and complications.(2)The surgical pathological records and surgical methods were collected.(3)The results of preoperative TTE diagnosis and surgical pathology were compared,and evaluated the accuracy rate of TTE examination in the diagnosis of SVA and combined with VSD,and analyzed the missed diagnosis and misdiagnosis cases.(4)The changes of preoperative and postoperative cardiac morphology and function in TTE examination were compared to evaluate the surgical efficacy.Results(1)All patients were confirmed through cardiac surgery,the diagnosis of TTE examination in SVA consistent with the result of surgery were65 cases,and misdiagnosis in 3 cases,which were diagnosed as other cardiovascular diseases by surgery,the accuracy rate of TTE examination in SVA diagnosis were 95.6%.(2)The common amalgamated malformation of SVA was VSD,35 cases of SVA patients were combined with VSD in this group,accounting for about 54%.25 cases of VSD were definitely detected by TTE,5cases were suspicious diagnosis by TTE,and 5 cases of small VSD were missed diagnosis.(3)The measured values of TTE examination for base diameter,long diameter and crevasse diameter of SVA were slightly larger than those values measured by surgery,and the difference was statistically significant(P<0.05).The measured values of VSD size was relatively smaller compared with the surgical measurement,and the difference was statistically significant(P < 0.05).(4)All the measurements of each cardiac cavity diameter were decreased after surgery within one week compared with preoperative values,and the differences were statistically significant(P < 0.05).The postoperative cardiac function of left ventricular were slightly lower than preoperative levels,but no statisticallydifference was found(P>0.05).The regurgitation of aortic valve,mitral valve and tricuspid valve were markedly reduced after surgery,and the differences were statistically significant(P<0.05).The regurgitation of pulmonary valve was slightly reduced,but there was no statistically significant(P > 0.05).Postoperative residual shunt was found in 1 case.Conclusion(1)TTE examination has high accuracy in the diagnosis of SVA and combined with VSD,though it was easy to miss diagnose the small VSD,it was still the preferred diagnostic method for SVA.(2)TTE examination would overestimate the diameter of SVA and relatively underestimate the diameter of combined VSD in a certain extent.(3)TTE examination can effectively evaluate the surgical efficacy of SVA,which has great significance for clinical practice.