小主动脉瓣环患者应用Regent机械瓣术后早中期疗效分析

柳祎; 孙宗全; 董念国; 杜心灵; 蒋雄刚; 胡琳

doi:10.13201/j.issn.1001-1439.2013.05.023

小主动脉瓣环患者应用Regent机械瓣术后早中期疗效分析

- 华中科技大学附属协和医院心脏外科(武汉, 430022)

详细信息

通讯作者: 胡琳,E-mail:xiaohulinzi@163.com

中图分类号: R542.5

收稿日期: 2013-04-21

Early and mid-term results after 17 mm St.Jude Medical Regent mechanical valve replacement in patients with small aortic valve ring

- Department of Cardiovascular Surgery, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: HU Lin, E-mail: xiaohulinzi@163.com

Received Date: 21 April 2013

摘要

摘要: 目的：观察小主动脉瓣环（直径17mm）患者行17mm St.Jude Medical Regent（SJM Regent）瓣膜置换术后是否存在植入瓣膜与患者不匹配现象。方法：对18例主动脉瓣环直径为17mm的患者置换17mm SJMRegent机械瓣（病例组），分别于术前、术后1周、术后3个月及术后6~12个月，采用彩色多普勒超声仪对左心功能指标进行监测，并与随机选择的同期18例置换21mm常规机械瓣的患者（对照组）进行比较。结果：2组围术期及术后12个月内均未发生心脏事件。2组术后左室舒张末期内径、左室后壁厚度、主动脉跨瓣压差等均较术前明显改善（均P<0.05），左室射血分数亦明显提高（均P<0.05），但2组间比较差异无统计学意义。结论：对于小主动脉瓣环（直径17mm）患者，置换17mm SJM Regent机械瓣后各指标已经接近或达到置换21mm常规瓣膜者，未发生植入瓣膜与患者不匹配现象，大部分小主动脉瓣环患者无需行主动脉瓣瓣环扩大术。
- 心脏瓣膜 /
- Regent机械瓣 /
- 小主动脉瓣环
Abstract: Objective: To observe outcomes of patients with small aortic valve ring after St.Jude Medical(SMJ)Regent mechanical valve replacement and to investigate the feasibility of small size prosthesis. Method: Eighteen patients received implantation of 17 mm SMJ Regent aortic prostheses(case group) and 18 patients received 21 mm St.Jude aortic prostheses(control group).All the patients followed up by 12 months. Result: Compared with pre-operation, patients in the two groups showed significant improvements in the left ventricular end-diastolic diameter, left ventricular posterior wall thickness, aortic pressure gradient and left ventricular ejection fraction(all P<0.05).However, there was no statistical difference between the two groups. Conclusion: For underweight patients and those with small body surface area, 17 mm SJM Regent valve prosthesis may produce good therapeutic effect, and some parameters are even close to those after implantation of 21 mm SJM Regent valve prosthesis.No obvious prosthesis-patient mismatch occurs after the placement of the 17 mm valve prosthesis and aortic valve ring expansion is not necessary.
- heart valve /
- Regent St.Jude Medical valve /
- small aortic valve ring

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参考文献(3)

[1]

RUEL M, AL-FALEH H, KULIK A, et al.Pros-thesis-patient mismatch after aortic valve replacement predominantly affects patients with preexisting left ventricul ardysfunction:effect on survival, freedom from heart failure, and left ventricular mass regres-sion[J].J Thorac Cardiovasc Surg, 2006, 131:1036-1044.

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YOSHIKAWA K, FUKUNAGA S, ARINAGA K, et al.Long-term results of aortic valve replacement with a small St.Jude medical valve in Japanese pa-tients[J].Ann Thorac Surg, 2008, 85:1303-1308.

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