渡辺 賢一¹, 永井 恒雄¹, 林 千治¹, 細川 修¹, 山添 優¹, 矢沢 良光¹, 柴田 昭¹, 林 純一², 大谷 信一², 江口 昭治²

Kenichi WATANABE¹, Tsuneo NAGAI¹, Senji HAYASHI¹, Osamu HOSOKAWA¹, Masaru YAMAZOE¹, Yoshimitsu YAZAWA¹, Akira SHIBATA¹, Junichi HAYASHI², Shinichi OHTANI², Shoji EGUCHI²

¹新潟大学医学部第一内科, ²新潟大学医学部第二外科

¹The First Department of Internal Medicine,Niigata University School of Medicine, ²The Second Department of Surgery, Niigata University School of Medicine

キーワード : pulsed Doppler technique, cardiac output, mitral valve replacement, size of mitral annulus

　Left ventricular volume change and inflow pattern in patients with prosthetic mitral valve were evaluated　non-invasively by a pulsed Doppler flowmeter combined with an electronic beam sector scanning echocardiography. 　20 subjects consisted of 10 patients with St. Jude Medical-27M (SJM, bi-leaflet center opening) and other ten with SJM-29M prosthetic valve. Left ventricular volume change was determined from left ventricular cineangiogram (LVG) based on the area-length method in 2 cases with sinus rhythm. Cardiac output obtained by thermodilution method was compared with that by Doppler's method. Velocities of diastolic left ventricular volume changes by LVG were matched to transmitral flow velocities (TFV), but total volumes by Doppler's method were larger than those by LVG. Cardiac output by Doppler's method showed a good correlation with that by thermodilution's method (r = 0.79 in 27M and 0.69 in 29M). These data indicate that TFV by Doppler flowmeter is useful for estimating instantaneous diastolic volume change of left ventricle and stroke volume non-invasively.