主动脉瓣环扩大术在主动脉瓣置换术中的应用

Effect of Aortic Annulus Plastic Enlargement on Aortic Valve Replacement

目的探讨主动脉瓣环扩大术在主动脉瓣环过小的主动脉瓣置换术中的应用效果。方法我院于2003年6月-2008年6月治疗主动脉瓣环过小的主动脉瓣膜病32例;平均年龄(24.2±13.3)岁,平均体重(42.2±16.7)kg。超声心动图提示主动脉瓣环直径平均(16.3±2.1)mm;13例采用Nicks方法,19例采用Manouguian方法进行主动脉根部成形及主动脉瓣置换术。同期施行合并病变手术矫治。结果全组无死亡病例。术后平均主动脉跨瓣压差为(24.2±8.4)mmHg(1mmHg=0.133kPa)。术后早期心律失常6例,肺感染并呼吸功能不全1例,均治愈。术后随访3～68个月,无远期死亡,未发生严重并发症。结论主动脉瓣环扩大术在主动脉瓣环过小的主动脉瓣置换术中能获得满意的治疗效果。

Objective To investigate the effect of aortic annulus plastic enlargement on aortic valve replacement in undersize aortic valve ring. Methods From June 2003 to June 2008,32 cases of aortic valve disease with undersize aortic valve ring, whose age ranged from 15 to 74 years and whose mean weight was （42.2 ± 16.7 ）kg,underwent aortic annulus plastic enlargement. The mean diameter of aortic valve ring was （ 16.3 ± 2.1 ） mm. 13 cases received Nicks＇ procedure and 19 cases received Manouguian＇ s procedure. The combined lesion was cured at the same time. Results No case died. Postoperative mean pressure gradient of aortic valve was（24.2± 8.4） mm Hg（ 1 mm Hg = 0. 133 kPa）. Complications in early stage including 6 cases of arrhythmia, 1 case of lung infection and respiratory failure, they were all cured. No death and other severe complication occurred in following up 3 to 68 months. Conclusion Therapeutic effect of aortic annulus plastic enlargement on aortic valve replacement in undersize aortic valve ring can be satisfied.