主动脉瓣机械瓣置换术后交替脉

Alternating Pulse An Interesting Phenomenon in the Early Period after Aortic Valve Replacement

报道４例因主动脉瓣关闭不全行主动脉瓣置换术后的患者在术后早期出现脉搏交替现象，此时心电图为整齐的窦性心律，所记录的脉搏图形高低交替，如扪诊桡动脉时则会发现桡动脉搏数为心电图示心率的一半。患者术后均顺利恢复，显示这一现象为一过性的、良性的过程。推测这一现象出现的原因可能是术后早期主动脉瓣不再有回流，因而巨大的左室腔充盈不足，加之左室收缩力尚低。

Alternating pulse occured in the early period after AVR in 4 cases of aortic regurgitation with large left ventricular cacity(LVEDD=67-79mm). This phenomenon was recorded as following:When the heart beat was in regular sinus rhythm,the pulse wave recorded by plethysmometer and/or arterial trace showed a higher wave followed by a lower wave alternatly.The alternating pulse usually disappeared in several hours after surgery. These patients recovered from surgery uneventfully.It is believed that this phenomenon is benign in nature and dose not predict a poor prognosis.