Monitoring And Analysis With Ultrasonic Cardiography After Orthotopic Heart Transplantation

Objective: To improve our knowledge about acute rejection of patients with orthotopic heart transplantation by analyzing ultrasonic cardiography and their changes , in order to improve our diagnostic and therapeutic management of this entity.Methods: In two patients with orthotopic heart transplantation operated in our hospital , the datas are gained by using SONOS-5500 mode ultrasonic machine made by American PHILIPS Corporation . The end- diastolic diameter of the atria and ventricles (LAd, RAd , LVd and RVd), the thickness of interventricular septum and left ventricular posterior wall ( IVS and LVPW), and pericardial effusion (PE) are measured by B-mode echocardiography; ejection fraction (EF) is measured by M-mode echocardiography and compared with the data gained using sinpson technique by B-mode echocardiography; the ventricular earlydiastolic filling peak velocity (VE), pressure half time (PHT), and isovolumetric relaxation time (IVRT) are measured by Doppler technique.Results: By analyzing each 15 checks of two patients with orthotopic heart transplantation, we can see that acute rejection . takes place at the 1-5 day and the 9th day following orthotopic heart transplantation on the first patient and occurs at the 1-6 day and the 9-11 day after orthotopic heart transplantation on the second patient. The differences of LAd,RAd, left ventricular mass (LVM) and PE between when acute rejection takes place and when the state of an illness is placid are meaningless . The differences of RVd , IVRT, PHE and Ve between when acute rejection takes place and when the state of an illness is placid are markedly. When acute rejection takes place , RVd is enlarged, IVRT and PHE are shortened, and VE is heightened. The differences of LVd, IVS and LVPW between when acute rejection takes place and when the state of an illness is placid are markedly about the first patient, but are meaningless about the second patient.Conclusions: The differences of RVd , IVRT, PHE and VE between when acute rejection takes place and when the state of an illness is placid are markedly, so these indexes can show the occurrence of acute rejection. The diagnosis is very nicety and sensitivity. And the ultrasonic cardiography is facility , well repeated and hurtles. Using ultrasonic cardiography in clinical workafter heart transplantation has bright futurity.