热解碳翼形双小叶心瓣在动物体内的血流动力学

Hemodynamics of Pyrolytic Carbon Cambered Bileaflet Valve in Animal

本工作对热解碳翼形双小叶心瓣在山羊身上进行了血流动力学性能的评价。用内径为16mm的这种人工心瓣作二尖瓣置换术。经换瓣前、后测量的左心房、室压力曲线及升主动脉的流量曲线而计算出经瓣压力降、经瓣血流量和心瓣有效开放面积分别为:0.57±0.16KPa对0.54±0.20KPa (P>0.5)、69.07±16.92ml.sec^(-1)对47.51±13.02ml.sec^(-1) (P<0.01)和1.10±0.28cm^2对0.77±0015cm^2(P<0.01)。与本研究室所研究的内径为20mm的YPV-Ⅰ型牦牛心包瓣膜相比,心瓣置换前的此三个参数和置换后的经瓣血流量无显著性差异(P>0.5)。但置换后,双小叶心瓣的经瓣平均压力降低于牦牛心包瓣(P<0.01);双小叶心瓣的有效开放面积大于牦牛心包瓣(P<0.01)。如果两种人工心瓣的尺寸相同,则本文研究的双小叶心瓣会有更好的血流动力学性能。

Pyrolytic carbon cambered bileaflet valve developed by Chengdu University of Technology and Science and west China University of Medical Sciences, was evaluated for its hemodynamics. The curved surface of the valve leaflet is cylindrical. Under anesthesia, cardiopulmonary by pass and chemical cardioplegia, a cambered bileaflet valve (i.d. =16 mm) was replaced at mitral position in each of 15 goats. Before valve replacement, average valvular pressure drop (AP)was 0.57 ±0.16 KPa, mitral flow rate (MFR) was 69.07±16.92 ml.sec^(-1) and effective opening area (EOA) of the valve was 1.10±0.28 cm^2. After valve replacement, corresponding hemodynamic parameters were 0.54±0.20 KPa, 47.51±13. 02 ml sec^(-1) and 0.77 ±+0.15 cm^2. In our previous report on yak pericardiac heart valve (i. d.=20 mm) in goats, corresponding hemodynamic parameters after valve replacement were 0.85±0. 32 KPa, 45.6±11. 8 ml sec^(-1) and 0.65±0.26 cm^2. With comparable MFR and heart beat(119.1±17.1 min^(-1) vs 119.4±17.9 min^(-1)) , the △P is significantly less for the present valve (P<0.001), and EOA is significantly larger (P<0. 01) for the present valye. Using the same size of these two types of valves, the hemodynamic parameters of cambered bileaflet valve would be better than those of yak pericardiac valve. Since the latter valve has been successfully used in patients, the present valve might be applicable in comparable clinical situations.