激光、外科超声震荡器、咬骨钳对主动脉瓣成形的比较

A Comparison of Er∶YSGG Laser, CUSA, and Rongeur in Calcific Aortic Valvuloplasty

为探讨新的心脏瓣膜成形途径，利用手术患者置换下来的新鲜主动脉瓣，比较研究激光（Ｅｒ∶ＹＳＧＧ）、外科超声震荡器（ＣＵＳＡ）及机械（咬骨钳）三种不同方法成形钙化狭窄的主动脉瓣的结果。研究表明：Ｅｒ∶ＹＳＧＧ激光（波长２７９０ｎｍ）明显优于外科超声震荡器和咬骨钳。它不但能够有效地清除钙化组织，而且具有成形精确、不易穿孔、热损伤范围小、成形后瓣膜表面光整、无胶原纤维暴露等长处，是成形这种钙化病变主动脉瓣较为理想的工具。

This study is designed to compare the efficacy and accuracy of the Er[KG-*1/3]∶YSGG laser, the Cavitron ultrasonic surgical aspirator (CUSA) and the mechanical method (rongeur) in aortic valvuloplasty. All the three methods were reported as to be able to debride the calcified tissue from aortic valves. However, our results showed the Er∶YSGG laser is more effective and more precise than CUSA and rongeur. It is less injurious and disruptive to the underlying valve tissue, and it does not result in valve perforation during decalcification. The debrided surface of aortic valve is smooth with less collagen exposure. The thermal injury is not associated with platelet accumulation on the debrided surface and prevents from fibroplastic aortic insufficiency. In conclusion, the Er∶YSGG is considered as an usefull tool in aortic valvuloplasty.