超声心动图评价小主动脉瓣环者机械瓣置换术后的心功能改变

Doppler echocardiographyic evaluation of heart function in patients with small aortic valve replacement

目的 探讨小主动脉瓣环病人行瓣膜置换术后的心功能改变。方法 1996年 1月至 1998年 12月间 ,2 1例主动脉瓣置换外径≤ 2 0mm机械瓣的病人 ,用彩色多普勒超声仪对左心功能进行术前、术后监测 ,并与 2 1例置换外径≥ 2 3mm机械瓣病人进行对比。结果 小主动脉瓣环者行瓣膜置换术后的左心功能指标较术前明显好转 ,左室射血分数、左室缩短分数、心室间隔厚度与后壁厚度之比有所上升 ,左室重量指数、左室壁厚度与左室腔半径之比及主动脉跨瓣压差均有不同程度降低。但与置换较大外径主动脉瓣病人的指标仍有差别。结论 置换较小外径的主动脉瓣 。

Objective: To evaluate the change of left heart function in patients with small aortic valve replacement. Methods: 21 patients receiving small valve prosthesis (≤20 mm in diameter) were studied by Doppler echocardiography(group I). Studies were done before the operation and 1-2 years after operation. The results were compared with those of 21 patients receiving bigger valve prosthesis (≥23 mm in diameter) (group II). Results: There was a significant increase in the left ventricular ejection fraction, fractional shortening, the ratio between interventricular septum and posterior wall thickness in both groups. There was a significant reduction in the left ventricular mass index, peak pressure gradients across aortic valve, the ratio between left ventricular wall thickness and left ventricular chamber radius in both groups. But the left heart function of the patients in group II was improved better than group I. Conclusion: Small aortic valve replacement can achieve a significant improvement of left heart function, but not as good as in bigger valve replacement.