主动脉瓣二瓣化畸形的血流动力学研究进展

Advances in hemodynamics of bicuspid aortic valve

主动脉瓣二瓣化畸形(bicuspid aortic valuve,BAV)是最常见的先天性心脏病,会导致升主动脉扩张、主动脉瘤、主动脉夹层等并发症,给致命性临床事件发生埋下隐患。与正常三叶式主动脉瓣相比,主动脉瓣二瓣化畸形会极大地改变血液从左心室射入主动脉的状态,破坏主动脉中生理状态的旋动流,改变主动脉的正常几何形态及生理功能。血流动力学环境的异常改变会引起瓣膜钙化、血管壁细胞衰退,致使瓣膜的力学性能显著降低,从而加速BAV疾病恶化。本研究旨在综述血流动力学因素在主动脉瓣二瓣化畸形及其并发症发展中的作用。

Bicuspid aortic valve(BAV)is the most common form of congenital heart defect,often leading to ascending aortic dilatation,aortic aneurysm and aortic dissection,making it a potentially lethal disease.It is demonstrated that the blood flow in normal human aorta exhibits a helical flow pattern and plays an important role in its physiology.Unlike the normal tricuspid aortic valve(TAV),the BAV greatly alters the blood flow injection from left ventricular to aorta and destroys the normal helical flow pattern in the aorta,which would affect the aortic geometry and physiology.Moreover,abnormal changes in the hemodynamic environment can lead to valve calcification and cell degeneration in aortic wall,resulting in significant decrease in valve mechanical properties,thus accelerating the deterioration and development of BAV diseases.This paper aims to review the role of hemodynamic factors in the development of aortic bicuspid malformations and their complications are reviewed.