一种新型人造心脏双叶瓣跨瓣压差的研究

STUDY OF THE TRANSVALVULAR GRADIENT OF A NEWLY CHINA-MADE BILEAFLET HEART VALVE PROSTHESIS

为了观察新型人造双叶瓣的跨瓣压差 ,在实验室、动物和临床上对该种人造瓣作了跨瓣压差的测定。 1.实验室测定 :在模拟人体生理循环条件下进行流体力学测试。通过自编数据处理程序对参数进行自动分析。 2 .动物实验测定 :手术中对置换 2 1mm型号二尖瓣的 6只羊用双导管法测定血流动力学 ;对 2只术后存活两年零五个月的羊先用超声法 ,然后用导管法并在多巴酚丁胺负荷下作血流动力学测定。 3.临床患者测定 :对 14只主动脉瓣和 10只二尖瓣用导管法和超声法测定。结果 :1.实验室测定 :测试瓣的ΔP ,均随心率增加而减低 ,ΔP在10mmHg以下。 2 .动物实验 :术中 6只羊的ΔP ,导管法 :5 .2mmHg± 1.7mmHg。 2只术后两年零五个月羊的ΔP ,超声法 :6 .8mmHg。 3.临床患者 :14只主动脉瓣ΔP ,导管法 :6 .2 4mmHg～ 4 .10mmHg ;超声法 :9.4 2mmHg～ 7.4 8mmHg。 10只二尖瓣ΔP ,导管法 :2 .1mmHg～ 1.9mmHg ;超声法 :5 .3mmHg～ 4 .1mmHg。结论 :新型人造双叶瓣平均跨瓣压差较低 ,具有良好的血流动力学效果。

To assess the transvalvular gradient of a newly China - made bileaflet heart valve prosthesis, the hydrodynamics were performed in the test and the hemodynamic performance were measured in the animals and patients. Methods 1. Test: the prosthesis has been tested in a pulsatile flow simulator in the aortic position. 2. Animal experiments: Six sheep that underwent mitral replacement with the prosthesis of 21mm were measured by open cardiac catheterization intraoperatively. Doppler echocardiography and open cardiac catheterization under dobutamine stress was performed in two sheep 2.5 years post - implant. 3. Patients measurements: 14 cases of aortic valve and 10 cases of mitral valve in the patients who underwent valve replacement with the heart valve prosthesis have been measured by open cardiac catheterization and Doppler echocardiography. Result: 1. Test: The newly heart valve prosthesis had the lower mean transvalvular gradient which was in the range of below 10 mmHg at any given tissue annulus diameter. 2. Animal experiments: The transvalvular gradients of 6 sheep were 5. 2mmHg ± 1.7mmHg intraoperatively and 2 sheep 2.5 years post - implant were 6.1mmHg ± 0.3mmHg by catheterization. 3. Patients measurement: The mean transvalvular gradients in the aortic position measured by means of catheterization and echocardiography were 6.26mmHg - 4.10mmHg and 9.42mmHg - 7.48 mmHg, respectively. The gradients in the mitral position were 2.10mmHg - 1.9mmHg and 5.281mmHg - 4. 10mmHg, respectively. Conclusion The results of this study demonstrated that the newly valve prosthesis has excellent hemodynamic performance.