瓣下结构对人工二尖瓣下游血流动力学的影响

Hemodynamics with different preservation of subvalvular apparatus

目的:明确保留瓣下结构对人工二尖瓣下游血流动力学的影响。方法:将入选的39例患者依据瓣下结构保留方式分为未保留组13例、保留后瓣组19例和保留全瓣组7例。检测常规、心功能、流场均匀性指标,然后应用计算机图像分析技术计算湍流剪应力(TSS)和相对扰动强度(Irel)。结果:保留瓣下结构可在一定程度上增加跨瓣血流的扰动性,使人工瓣下游流场均匀性变差,TSS和Irel增大(P<0.05)。结论:保留后瓣瓣下结构可能更适合患者。

Objective：To research the effect on preservation of subvalvular apparatus interfered with the hemo- dynamic actions downstream of prosthetic mitral valve. Method：The 39 patients were divided into non-preservation group, posterior preservation group and all preservation group, according to different preservation of subvavular apparatus. PG Qmv, LVEF, LVESD, Vmax, AVmax were measured by Doppler eehocardiography. TSS and Irel were computed by Doppler echocardiography. Result： TSS and Irel were increased in all preservation group. Preservation of suhvalvular apparatus to some extent resulted in an incremental disturbance of transvalvular flow, which causes that the flow field uniformity worse in the downstream of prosthetic mitral valve. Conclusion： Preserve posterior subvalvular apparatus may be more beneficial to most patients.