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|本期目录/Table of Contents|

新型无支架生物瓣带瓣管道用于右室流出道重建

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第1期
页码:
64-67，71
栏目:
临床研究
出版日期:
2010-01-04

文章信息/Info

Title:
Stentless valved conduit bioprostheses for right ventricular outflow tract reconstruction
作者:
张玉景1; 2; 魏旭峰1; 陈涛1; 金艳1; 顾春虎1; 王红兵1; 易定华1
1.第四军医大学西京医院心血管外科，陕西 西安 710033；2.解放军第97医院胸心外科，江苏 徐州 221004
Author(s):
ZHANG Yu-jing1; 2; WEI Xu-feng1; CHEN Tao1; JIN Yan1; GU Chun-hu1; WANG Hong-bing1; YI Ding-hua1
1.Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710033, Shaanxi, China; 2.Department of Thoracic and Cardiovascular Surgery, PLA 97th Hospital, Xuzhou 221004, Jiangsu, China
关键词:
带瓣管道; 先天性心脏病; 右室流出道; 重建
Keywords:
valved conduit;  congenital heart disease;  right ventricular outflow tract;  reconstruction
分类号:
R654.2
DOI:
-
文献标识码:
A
摘要:
目的: 验证新型无支架生物瓣带瓣管道应用于右室流出道重建术中的有效性和安全性。方法: 2007年11月~2008年5月，全组7例复杂先天性心脏病患者使用了新型无支架牛心包带瓣管道重建右室流出道，其中Rastelli手术6例、Nikaidoh手术1例。通过术后不同时期超声检查结果，记录肺动脉压、血流速度、新建肺动脉瓣跨瓣压差及开口面积和返流情况，了解肺动脉管道直径、有无瘤样扩张以及远端吻合口压差等，对移植的无支架生物瓣带瓣管道的临床性能进行评价。结果: 所有患者住院期间均无吻合口渗血、心内膜炎、血栓栓塞等带瓣管道相关并发症发生，恢复顺利，均治愈出院。术后1~4月和6月以上超声检查均提示移植的管道通畅，管壁无变薄、钙化，无瘤样扩张，无明显肺动脉瓣返流等。结论: 新型无支架生物瓣带瓣管道具有管壁弹性好、易于缝合、术后排斥反应少等优点，且有良好抗返流作用，早期疗效满意。
Abstract:
AIM: To explore the efficacy and safety of new stentless valved conduit bioprostheses (SVCB) in right ventricular outflow tract (RVOT) reconstruction. METHODS: ROVT reconstruction was performed with SVCB in seven patients (six cases of Rastelli and one case of Nikaidoh) between November 2007 and May 2008. The implanted SVCB was evaluated by Doppler echocardiography after operation with the following parameters: pulmonary artery pressure, flow velocity, pulmonary transvalvular pressure gradient (PG), valvular orifice area, regurgitation, conduit diameter, dilatation and remote anastomotic pressure gradient. RESULTS: All seven patients evolved well postoperatively without valved conduit-related complications such as anastomotic bleeding, endocarditis, and thromboembolism. By serial sonography, no apparent signs of valve regurgitation, degeneration or calcification were observed in the conduit during the entire follow-up period. CONCLUSION: The new type of SVCB demonstrates good flexibility, easy perioperative surgical handling and less postoperative rejection. It has good anti-regurgitation and PG effect post-operation, which facilitates cardiac function recovery.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2009-1-9.基金项目：国家863计划“新型人工心脏瓣膜的研制和临床应用”（2006AA02A138） 通讯作者：易定华，主任医师，主要从事冠心病、复杂先心病和心脏移植研究Email:yidh@fmmu.edu.cn 作者简介：张玉景，主治医师，硕士生Email:zyjly88@126.com
更新日期/Last Update: 2010-01-05