三尖瓣和乳头肌移植的实验研究

Experimental Study of Transplantation of Tricuspid Valve and Papillary Muscles

为观察三尖瓣前叶及乳头肌切下再原位、异位移植后组织愈合情况和功能状态 ,为临床工作提供实验依据。将 1 0条健康成年杂种犬随机分为 2组 ,A组 :从根部切下前乳头肌 ,缝合于原位切断处 ;沿瓣环切下三尖瓣前叶 ,间断缝合于原位 ;B组 :瓣叶及乳头肌切断同A组 ,将乳头肌缝合固定于原根部上方 3mm处的心室壁上 ,将三尖瓣前叶缝合在距离原瓣环上方 3mm处的心房壁上。 2组犬在术前、术后即刻和术后 4周测量血流动力学参数 ;术前及术后 4周应用超声心动图观察三尖瓣闭合情况 ;术后 4周观察愈合处的组织学改变。结果 :术后 4周 ,2组犬的三尖瓣瓣叶及乳头肌组织愈合良好、血流动力学稳定 ,原位组三尖瓣闭合尚好。提示 :无论原位移植还是异位移植 ,三尖瓣瓣叶和乳头肌均能良好愈合 ,右室功能恢复满意 ,异位移植组的三尖瓣返流较原位移植组明显。

The aim was to observe tissue healing and function of tricuspid anterior leaflet and papillary muscles after being sutured to original place or to another place and to provide experimental basis for clinical work. Ten mongrel dogs were randomly divided into two groups. Group A: tricuspid anterior leaflet and papillary muscle were sutured to original place, group B: anterior leaflet and papillary muscle were sutured to another place 3 cm higher than original. The indices of hemodynamics of the heart were measured before and after the operation and four weeks after the operation; Function of tricuspid valve and tissue healing were also observed 4 weeks after operation. We found that the indices of hemodynamics of hearts in both groups were stable, the tissue healing and function of tricuspid valve were satisfactory. The conclusion is whether the tricuspid valve and papillary muscles are sutured to orignal or to another place they can be well healed.