生物瓣膜原发性组织衰坏——放射、光镜和电镜观察

PRIMARY TISSUE FAILURE OF BIOPROSTHETIC HEART VALVES-RADIOLOGY,LIGHT MICROSCOPIG AND ELECTRONIC MICROSCOPIC STUDY

1983年3月～1990年6月,61个生物瓣因原发性组织衰坏而行再换瓣术,对取出的瓣膜作大体、放射、光镜和电镜观察。发现猪主动脉瓣以钙化为主,牛心包瓣以撕裂为主,钙化主要发生在交界,撕裂以Ⅰ型为主。光镜和电镜下表现为:(1)胶原纤维变性、断裂;(2)钙化;(3)血细胞浸润;(4)上皮细胞层消失,瓣环口结缔组织增生;(5)微血栓。电镜还发现血浆蛋白和脂肪浸润。未植入的猪主动脉瓣保存1年时,组织细胞结构即有改变。

From March,1983 to June,1990,sixty-one bioprosthetic heart valves were replaced due to primary tissue failure.The removed valves were studied by macroscopy,radiology, light microscopy and electronic microscopy.The main cause of failure was calcification for porcine aortic valves and tears for bovine pericardial valves.Calcification mainly located at commissures.Tears of pericardial valves were started at alignment suture of commissure at the top of stent,progressing to the valve base.The findings of light microscopy and elec- tronic microscopy were:1)disruption of collagen fibers; 2)calcification; 3)cell infiltration; 4)disappearance of endothelium; 5)microemboli.In addition,infiltration of plasma and lipoid substances were found under electronic microscopic examination.The structures of unimplantanted porcine aortic valves were changed after preservation for one year.