Evaluation Of The Changs Of Left Atrial Before And After The Mitral Valvuloplasty Directed By Real-time Three-dimensional Echocardiography

Objective:To evaluate the changes of preoperative and postoperative leftatrial storage, conduit, auxiliary pump function quantitatively and theeffects on left ventricular diastolic function in patients with mitral valveprolapse by real-time three-dimensional echocardiography.Methods:Select30cases mitral valve prolapse patients underwent mitral valverepair in our hospital during January2012to december2013.They aredivided into four groups: preoperative group (group A), one months afteroperation (group B), three months after operation (group C), six monthsafter operation (group D). Routine ultrasound examination to measureanteroposterior diameter(LAD-AP), left-right diameter(LAD-LR) and leftventricular end-diastolic diameter (LVDD). Applicated with the real-timethree-dimensional echocardiography (RT-3DE) acquisition of all subjectswith standard apical four chamber view full volume images, connectedsynchronous electrocardiogram, introducted into Qlab software andmeasured of the maximum volume of left atrial (LAVmax), left atrialminimum volume (LAVmin), left atrial volume before contraction whichis the R wave to be (LAVpre). Application of SPSS21.0for statisticalanalysis, using P＜0.05, the difference was statistically significant.Results:(1) compared the change of left atrial general measurements MVr in the preoperative, postoperative: LAD-AP, LAD-LR, LVDD values ofgroups B，C，D were lower than group A，with statistically significantdifference(P＜0.01). It had no significant difference among thegroups B，C，D(P>0.05).(2) compared the change of left atrial volumeMVr in the preoperative, postoperative: LAVmaxI, LAVminI, LAVpreIvalues of groups B，C，D were lower than those in group A，withstatistically significant difference(P <0.01). LAVmaxI, LAVminI valuesof group C and group D were lower than group B (P <0.05), but nosignificant difference between group D and group C (P>0.05).(3)compared the change of left atrial function MVr in the preoperative,postoperative: LAEF, LAEFpassive, TASVI, PASVI, AASVI values ofgroups B，C，D were higher than those in group A，with statisticallysignificant(P <0.01). LAEFactive values of groups B，C，D were higherthan those in group A，with statistically significant(P <0.05). LAEF andLAEFactive values were significant difference among the groups B，C，D (P <0.05), but LAEFpassive values between the three groups were nosignificant difference (P>0.05).Conclusion:Because of the reduction of valve regurgitation area after mitralvalvuloplasty, left atrial volume and pressure load reduced, left atrialremodeled. Left atrial storage, conduit and auxiliary pump functionwere in different degree of improvement. Systolic function improvedobviously, pipeline function postoperatively is relatively stable.