经导管主动脉瓣及肺动脉瓣置换的应用解剖

Applied anatomy of transcatheter aortic and pulmonary valve replacement

目的:为经导管瓣膜置换提供正常人主动脉瓣膜及肺动脉瓣膜的相关应用解剖。方法:解剖测量40例(男28,女12)外形大小正常的成年人心标本。结果:测得主动脉瓣、肺动脉瓣周径分别为(63.25±8.43)mm、(66.52±11.25)mm;瓣膜游离缘长度分别为(26.25±3.84)mm、(27.51±5.15)mm;瓣膜附着缘长度分别为(20.36±3.51)mm、(21.27±4.64)mm;游离缘距窦底的距离分别为(15.15±2.67)mm、(16.54±4.33)mm。左、右冠状动脉开口距主动脉根部距离分别为(16.59±4.16)mm、(17.23±3.26)mm。主肺动脉长度(33.54±8.15)mm。结论:带瓣膜支架的大小和形状的设计应根据主动脉以及主肺动脉开口的大小及与周边结构的关系来选择。

Objective： To understand the anatomical characteristics of the aortic valve and pulmonary valve of normal adult heart and provide anatomical basis for transcatheter aortic valve and pulmonary valve replacement. Methods： 40 adult heart specimens （ 28 male and 12 female） were dissected and measured. Results： The perimeter of aortic valve and pulmonary valve were （63.25 ±8.43）mm and （66.52±11.25）mm respectively. The lengths of flee margin were （26.25 ±3.84） mm and （27.51±5.15） mm respectively. The length of attachment margin were （20.36±3.51 ） mm and （21.27±4.64） mm respectively. The length from free margin to sinus bottom were （ 15.15±2.67）mm and（ 16.54±4.33 ）mm respectively. The distances from the aortic root to left and right coronary artery opening were （16.59±4.16） mm and （17.23±3.26） mm respectively. The long diameter of primary pulmonary artery was （33.54 ±8.15） mm. Conclusions： The size and shape of the stent with valve selected base on the size of the opening of the aortic and primary pulmonary artery and the distance from the opening to other structures.