St.Jude Medical Regent主动脉瓣应用于小主动脉瓣环患者的初步经验

Initial experience with using St. Jude Medical Regent mechanical aortic valve in patients with small aortic root

目的总结对小主动脉瓣环患者行St.JudeRegent主动脉瓣替换的初步经验。方法对11例小瓣环主动脉瓣病变患者行St.JudeRegent主动脉瓣替换。患者平均年龄(42.9±13.1)岁,体重(68.2±10.1)kg,体表面积(1.71±0.13)m2。术前主动脉瓣跨瓣峰值压差平均(74.4±34.3)mmHg。替换19号St.JudeRegent主动脉瓣7例,21号4例。结果本组患者无手术死亡,无严重并发症。平均输血量227.3ml,4例未输血。随访无远期死亡。术后患者心功能较术前明显改善。术后6个月复查超声心动图,提示肥厚的左心室显著退缩,人工瓣跨瓣峰值压差为(20.8±5.0)mmHg。19号瓣平均有效瓣口面积为(1.68±0.17)cm2,21号瓣为(1.96±0.25)cm2。结论小瓣环主动脉瓣病变患者行St.JudeRegent主动脉瓣替换的近期效果良好。

Objective To evaluate our preliminary experience of aortic valve replacement （AVR） with St. Jude Medical Regent prosthesis in patients with small aortic root. Methods Between May 2004 and January 2005, 11 patients with small aortic root underwent implantation of a Regent mechanical aortic valve prosthesis, of whom mean weight was （68.2±10.1）kg, mean body surface area was （1.71±0.13）m^2. 19 mm and 21 mm Regent valve were implanted in 7 and 4 patients respectively. Results No patient experienced major complications related to the operation, mean blood transfusion volume was 227.3 ml while no transfusion was needed in 4 patients. All patients had improved in NYHA functional class. At 6 months, echocardiography revealed significant left ventricular regression. Transvalvular peak gradients was （20.8±5.0）mm Hg. Effective orifice areas were （1.68±0.17）cm^2 andl.96±0.25 cm^2 for valve sizes 19 mm and 21 mm respectively. No thrombo-embolic events were observed within the follow-up period. Conclusion The SJM Regent valve shows excellent in vivo hemodynamic performance,providing a simply and effective option for patients with small aortic root. The early experience with the SJM Regent valve has been satisfactory.