彩色多普勒超声心动图评估人工瓣膜置换后形态学及生物相容性

Morphology and biocompatibility of prosthetic valve after replacement evaluated by color Doppler echocardiography

目前人工瓣膜大多数为机械瓣和生物瓣,机械瓣经过多年的工艺发展已经由球瓣、斜碟瓣发展到目前应用较广泛的双叶瓣。生物瓣具有血流动力学性能优秀,不需终生抗凝等优点,但机械瓣的生物相容性较差、生物瓣易退化损坏等问题,使人们开始对新的瓣膜制作材料进行研究,使用高分子材料制成的无支架带腱索生物二尖瓣与自然瓣膜相似,可维持人体二尖瓣生理功能、左室几何形状和血流动力学。人工瓣膜的血流动力学性能通常用跨瓣压差、有效瓣口面积、关闭量和泄漏量等指标来评价,彩色多普勒超声心动图作为无创性的检查手段,在评价其血流动力学方面有着较大的临床意义及实用价值。

Presently, prosthetic valve is mainly composed of mechanical prosthetic valve and biological valve. With the development of technique, mechanical prosthetic valve has changed from ball valve and tilting disc valve to presently commonly used bilobed flap. Biological valve is characterized by good function of hemodynamics and no lifetime anticoagulation. However, mechanical prosthetic valve has poor biocompatibility, and biological valve is easy to degrade and to be damaged. People have studied a new material to make valve. Giant molecule materials-made no-stent bio-mitral valve with chordae tendineae is similar to normal valve. This bio-mitral valve can maintain physiologic function of human mitral valve, geometry of the left ventricle and hemodynamics. The hemodynamics of prosthetic valve is generally assessed by mitral pressure gradient, effective orifice area, closing amount and leakage volume. Color Doppler echocardiography, as a non-invasive method, has a great clinical significance and practical value on assessing the hemodynamics of prosthetic valve.