肺动脉瓣前瓣移植治疗主动脉瓣单瓣病变

Anterior valve of the pulmonary valve transplantation in the treatment of single aortic valve disease

目的 探讨肺动脉瓣前瓣移植治疗主动脉瓣单瓣病变的手术方法.方法 完成猪心瓣膜模型18例.主动脉瓣组10例：利用肺动脉瓣前瓣作主动脉根部移植、置换单个主动脉瓣.肺动脉瓣组8例：切取肺动脉瓣前瓣、利用心包修补成形肺动脉.结果 主动脉瓣组术前主动脉瓣跨瓣压差脉动流为2.08 kPa、连续流为1.70 kPa,术后主动脉瓣跨瓣压差脉动流为3.10 kPa、连续流为2.46 kPa,手术前后差异无统计学意义（P＞0.05）.肺动脉瓣组术前肺动脉瓣跨瓣压差脉动流为1.00 kPa、连续流为0.77 kPa,术后肺动脉瓣跨瓣压差脉动流为1.29 kPa、连续流为1.04 kPa,手术前后无显著变化（P＞0.05）.主动脉瓣、肺动脉瓣手术后功能良好,均无轻度以上返流.结论 肺动脉瓣前瓣移植后表现出良好血流动力学状态.

Objective To discuss the partial pulmonary artery with front valve for aortic root transplantation in the treatment of aortic valve of a single valve lesions.Methods Complete animal experiments in vitro pig heart valve model 18 cases.10 cases of aortic valve group：using part of the pulmonary artery with front disc,a single aortic valve replacement for aortic root transplantation.8 cases pulmonary valve group：Taking part of the pulmonary artery with front disc,pericardial patch shape after pulmonary artery.Results Preoperative aortic cross valve differential pressure pulsation flow state of 2.08 kPa,continuous flow condition of 1.70 kPa.Postoperative aortic cross valve differential pressure pulsation flow state of 3.10 kPa,continuous flow condition of 2.46 kPa.Aortic cross valve pressure difference before and after surgery had no significant change （P ＞ 0.05）.Preoperative pulmonary valve across valve differential pressure pulsation flow state of 1.00 kPa,continuous flow condition of 0.77 kPa.Postoperative pulmonary valve across valve differential pressure pulsation flow state of 1.29 kPa,continuous flow condition of 1.04 kPa.Across pulmonary valve differential pressure tban before surgery had no significant change （P ＞ 0.05）.Aortic valve and pulmonary valve function well after the surgery,no more than mild reflux.Conclusion Part of the pulmonary artery with front disc showed good hemodynamic status.