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|本期目录/Table of Contents|

非缝合式无支架异种主动脉生物瓣膜的研制

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第2期
页码:
250-254
栏目:
临床研究
出版日期:
2010-12-10

文章信息/Info

Title:
Research on sutureless and stentless heterologous aortic bioprosthesis
作者:
徐驰1; 2; 曹燕飞3; 陈炜生2; 姜淑云4; 陈龙2; 盛继红2; 李慧忠2
1.解放军总医院胸外科，北京 100853；2.南京军区福州总医院心胸外科，福州 350025；3.陕西省人民医院心胸外科，陕西 西安 710061；4.南京医科大学附属无锡市人民医院重症监护科，江苏 无锡 214023
Author(s):
XU Chi1; 2;  CAO Yan-fei3;  CHEN Wei-sheng2;  JIANG Shu-yun4;  CHEN Long2;  SHENG Ji-hong2;  LI Hui-zhong2
1.Department of Thoracic Surgery, PLA General Hospital, Beijing 100853, China; 2.Department of Cardiothoracic Surgery, Fuzhou General Hospital, Fuzhou 350025, Fujian, China; 3.Department of Cardiothoracic Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710061, Shaanxi, China; 4.ICU, Affiliated Wuxi People’s Hospital, Nanjing Medical University, Wuxi 214023, Jiangsu, China
关键词:
异种主动脉生物瓣膜; 无支架; 非缝合式; 脉动流实验
Keywords:
heterologous aortic bioprosthesis;  stentless;  sutureless;  pulsatile flow testing
分类号:
R543.1;R318.11
DOI:
-
文献标识码:
A
摘要:
目的: 研制新型非缝合式无支架异种主动脉生物瓣膜，在体外对其功能进行初步研究。方法： 将猪主动脉瓣缝合到NiTi形状记忆合金支架上，在离体猪心脏内置入新型瓣膜，肉眼及彩超下观测瓣膜闭合、冠状动脉血流及瓣周漏情况。通过TH-1200型人工心脏瓣膜脉动流测试系统测定25#非缝合式无支架异种主动脉生物瓣膜平均跨瓣压差、返流百分比、瓣膜开口面积。结果： 新型瓣膜能较简单的植入离体猪心脏内。且不同压力（80～250mmHg）下，瓣膜闭合良好，无明显瓣周漏，冠状动脉血流良好；心脏彩超检测瓣周结构与主动脉壁之间可见无回声间隙，无明显的瓣周漏。体外脉动实验提示新型瓣膜与机械瓣膜相比跨瓣压差小，返流少，开口面积大。结论： 该型瓣膜制备相对简单，具有血流动力学良好，跨瓣压小，无需抗凝等优点，可简化手术操作，降低手术难度。
Abstract:
AIM: To devise a new sutureless and stentless heterologous aortic bioprosthesis and to test the function of the new valve in vitro. METHODS: The pig aortic valve was sewn in the NiTi shape memory alloy stent and the new valve was then inserted in a pig heart in vitro. Valve closure, coronary blood flow and parabasilar leak were observed by the naked eye and color Doppler ultrasound. New type valves (#25) and mechanical valves (#25) were tested and compared by TH-1200 H.V. Prosthesis Pulsatile Flow Tester in vitro. Mean transvalvular pressure gradient, effective orifice area and regurgitant fraction were also tested. RESULTS: The new sutureless and stentless autologous aortic bioprosthesis was easily inserted into the pig heart in vitro. Between different pressures (80-250 mmHg), the valve closure was good without apparent perivalvular leakage. Coronary blood flow was smooth. The valves had a tight closure, and no apparent parabasilar leak was observed under color Doppler ultrasound. The new-type valves had less mean transvalvular gradient, less regurgitation and more effective orifice area compared with mechanical valves. CONCLUSION: It is relatively easy to make the new valves. Sutureless and stentless heterologous aortic bioprostheses are characterized by excellent hemodynamic flow and lower transvalvular pressure gradient. Their use simplifies the operative process, thus making performance of the procedure easier.

参考文献/References

[1]张中明. 无支架异种生物瓣膜主动脉瓣替换的临床应用［J］. 国外医学·心血管疾病分册, 1997, 24(1):11-14.

[2]Lichtenstein SV, Cheung A, Ye J, et al. Transapical transcatheter aortic valve implantation in humans: Initial clinical experience［J］. Circulation, 2006, 114(6):591-596.

[3]Huber CH, Von Segesser LK. Direct Access Valve Replacement（DAVR）-are we entering a new era in cardiac surgery?［J］. Eur J Cardiothorac Surg, 2006, 29(3):380-385.

[4]王同建,乔杉,张锋泉,等. 无支架Baxter主动脉生物瓣膜的临床应用［J］. 实用医药杂志, 2002, 19(7):485-486.

[5]Del Rizzo DF, Goldman BS, Christakis GT, et al. Hemodynamic benefits of the Torono stentless valve［J］. J Thorac Cardiovasc Surg, 1996, 112(6):1431-1445.

[6]Bhatnagar G, Christakis GT, Murphy PM, et al. Technique for reconstruction of the sinotubular junction［J］. Ann Thorac Surg, 1997, 63(2):559-560.

[7]Thiem A, Cremer J, Lutter G. Percutaneous valve replacement: Weird or wonderful?［J］. Minerva Cardioangiol, 2006, 54(1):23-30.

[8]Vahanian A, Alfieri OR, Al-Attar N, et al. Transcatheter valve implantation for patients with aortic stenosis: A position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI)［J］. Eur J Cardiothorac Surg, 2008, 34(1):1-8.

[9]Stevenson DM, Yoganathan AP, Franch RH. The Bjrk-Shiley heart valve prosthesis. Flow characteristics of the new 70 degrees model［J］. Scand J Thorac Cardiovasc Surg, 1982, 16(1):1-7.

备注/Memo

备注/Memo:
收稿日期：2010-05-12.基金项目：福建省自然科学基金面上项目资助（2007J0109） 作者简介：徐驰，主治医师，硕士生Email:xcc145@sina.com
更新日期/Last Update: 2010-12-10