牛颈静脉带瓣管道重建犬右心室流出道及其血流动力学研究

Hemodynamic study of right ventricular outflow tract reconstruction with valved boving jugular vein conduit in canine model

目的观察自制牛颈静脉带瓣管道(VBJVC)重建右心室流出道术后的血流动力学改变。方法用戊二醛(GA)处理的VBJVC对6只犬(犬1、2、3、4、5和6)行右心室肺动脉重建术。并使用心导管测定术前、后及术后1～2年右心室及肺动脉压力,结合使用超声心动图检查和右心室造影,评价血流动力学改变。结果犬1于术后24 h死亡,犬2、4、5存活14～18个月死亡,犬3、6健康存活2年多。重建右心室流出道手术前、后及术后1～2年,右心室压及肺动脉压(包括收缩压、舒张压、平均压)无明显变化。右心室与肺动脉收缩压差仅1.0～2.4 mm Hg,右心室舒张压均正常。术后1～2年超声心动图及右心室造影检查,管道无狭窄,瓣膜活动自如,无明显增厚,关闭良好,无反流。结论经戊二醛处理的VBJVC重建犬右心室流出道具有良好的血流动力学性能。

Objective To investigate the hemodynamic performance of valved bovine jugular vein conduits（VBJVC）for right ventricular outflow tract reconstruction in canine model.Methods The VBJVC that were treated with the glutaraldehyde（GA） were implanted between the pulmonary artery and right ventricle in six canines.Use cardiac catheterization to measure right ventricular and pulmonary artery pressures before and after one to two years the implantation.Hemodynamic evaluation were carried out by united echocardiography and right ventricular angiography.Results The canine 1 was died at 24 hours after operation,canine 2,4,5 surrived 14 to 18 mothes,the canine 3,6 survived more than two years.The right ventricular and pulmonary artery pressure（including systolic pressure,diastolic pressure and mean pressure） had not significantly changed before and after one to two years the right ventricular outflow tract reconstrution.The systolic pressure gradients between the right ventricle and the pulmonary artery from 1.0 to 2.4 mm Hg.The right ventricular diastolic pressure had not increased.After one to two years reconstruction with the VBJVC the echocardiography and right ventricular angiography showed the conduit had no obvious obstruction and valve motion no obvious regurgitation with no obvious thickening of the leaflets.Conclusion The GA fixed VBJVC has good hemodynamic performance of right ventricular outflow tract reconstruction in canine.