目的:回顾性分析MEDTRONIC Open Pivot主动脉瓣机械瓣置换术后早中期临床结果。方法:连续收集2016年1月至2019年12月在中国医学科学院阜外医院使用MEDTRONIC Open Pivot主动脉瓣机械瓣行瓣膜置换术的患者348例,回顾性分析患者的基线临...目的:回顾性分析MEDTRONIC Open Pivot主动脉瓣机械瓣置换术后早中期临床结果。方法:连续收集2016年1月至2019年12月在中国医学科学院阜外医院使用MEDTRONIC Open Pivot主动脉瓣机械瓣行瓣膜置换术的患者348例,回顾性分析患者的基线临床资料、手术结果、早中期生存率和并发症发生情况。结果:348例患者中,男性283例(81.3%),平均年龄(49.4±11.2)岁。围术期无患者死亡和二次手术。共333例(95.7%)患者完成随访,平均随访(1.9±0.8)年(最长3.36年,共计627人年)。随访期间,11例(3.3%)患者死亡,术后第1、2、3、4年分别死亡3例、2例、5例、1例;5例死于心力衰竭,1例死因为人工瓣膜功能障碍,1例因脑出血死亡,4例为其他非心脑血管原因死亡。术后1年、2年、3年累积生存率分别为99.0%、98.1%、93.5%。随访期间,14例(4.2%)患者出现人工瓣膜功能障碍,发生率为2.23%/人年;6例(1.8%)患者出现瓣周漏,发生率为0.96%/人年;2例(0.6%)患者因严重瓣周漏需二次接受手术。17例(5.1%)患者发生主要不良事件,其中心肌梗死1例(0.3%),脑出血2例(0.6%),脑栓塞1例(0.3%),其他严重出血事件13例(3.9%)。结论:MEDTRONIC Open Pivot主动脉瓣机械瓣有效、耐用,置换术后死亡率及并发症发生率低,是主动脉瓣膜置换的可靠选择之一。展开更多
Medtronic公司5月12日宣布旗下最新一代预防卒中的Arctic Front Advance ST Cryoablation Catheter（冷冻球囊）刚刚获得了FDA和CE批准。冷冻球囊用于在微创介入手术中隔离心房肺静脉,使用冷却剂消融（或去除）与心房颤动相关的紊乱组织...Medtronic公司5月12日宣布旗下最新一代预防卒中的Arctic Front Advance ST Cryoablation Catheter（冷冻球囊）刚刚获得了FDA和CE批准。冷冻球囊用于在微创介入手术中隔离心房肺静脉,使用冷却剂消融（或去除）与心房颤动相关的紊乱组织,而房颤与中风和心力衰竭关系密切。该器械的头端更短,设计帮助术者更好地实时观察及提高导管的操控性。展开更多
Aim of the study: Several studies have shown the inferior performance of small prostheses in the narrowaortic root. However, modern low-profile mechanical prostheses have improved hemodynamic performance characteristi...Aim of the study: Several studies have shown the inferior performance of small prostheses in the narrowaortic root. However, modern low-profile mechanical prostheses have improved hemodynamic performance characteristics. By measuring the transprosthetic pressure gradient in vivo, we were able to characterize the hemodynamic features of two prostheses: the ATS Medical(ATS) and the Medtronic Hall(MH) valves. Methods: From October 1994 to April 2002, 113 patients received an aortic valve replacement(AVR) with either an ATS or a MH valve. The transprosthetic pressure gradients, calculated froma simplified Bernoulli equation during immediate postoperative Doppler echocardiographic examination, were compared for differently sized prostheses with respect to body surface area(BSA). Results: The mean pressure gradients and the mean BSAs were: 27.8±14.8 mm Hg and 1.50±0.10 m2 in ATS 19 mm(n=7), 20.4±8.5 mm Hg and 1.54±0.11 m2 in ATS 21 mm(n=22), 13.0±5.7 mm Hg, 1.70±0.13 m2 in ATS 23 mm(n=22), 10.9±3.5 mm Hg and 1.81±0.16 m2 in ATS 25 mm(n=19), 9.3±0.6 mm Hg and 1.72±0.17 m2 in ATS 27 mm(n=4), 13.5±6.5 mm Hg and 1.54±0.13 m2 in MH 20 mm(n=9), 10.9±4.7 mm Hg and 1.64±0.15 m2 in MH 22 mm(n=22), 9.3±3.1mmHg and 1.72±0.12 m2 in MH 24 mm(n=7). Conclusions: With the exception of the ATS 19mm valve, the variously sized prostheses have acceptable transprosthetic pressure gradient measurements. In addition, even-sized MH valves(20 and 22 mm) with a thinner sewing cuff showed better hemodynamic performances than similarly sized ATS valves.展开更多
文摘目的:回顾性分析MEDTRONIC Open Pivot主动脉瓣机械瓣置换术后早中期临床结果。方法:连续收集2016年1月至2019年12月在中国医学科学院阜外医院使用MEDTRONIC Open Pivot主动脉瓣机械瓣行瓣膜置换术的患者348例,回顾性分析患者的基线临床资料、手术结果、早中期生存率和并发症发生情况。结果:348例患者中,男性283例(81.3%),平均年龄(49.4±11.2)岁。围术期无患者死亡和二次手术。共333例(95.7%)患者完成随访,平均随访(1.9±0.8)年(最长3.36年,共计627人年)。随访期间,11例(3.3%)患者死亡,术后第1、2、3、4年分别死亡3例、2例、5例、1例;5例死于心力衰竭,1例死因为人工瓣膜功能障碍,1例因脑出血死亡,4例为其他非心脑血管原因死亡。术后1年、2年、3年累积生存率分别为99.0%、98.1%、93.5%。随访期间,14例(4.2%)患者出现人工瓣膜功能障碍,发生率为2.23%/人年;6例(1.8%)患者出现瓣周漏,发生率为0.96%/人年;2例(0.6%)患者因严重瓣周漏需二次接受手术。17例(5.1%)患者发生主要不良事件,其中心肌梗死1例(0.3%),脑出血2例(0.6%),脑栓塞1例(0.3%),其他严重出血事件13例(3.9%)。结论:MEDTRONIC Open Pivot主动脉瓣机械瓣有效、耐用,置换术后死亡率及并发症发生率低,是主动脉瓣膜置换的可靠选择之一。
文摘Medtronic公司5月12日宣布旗下最新一代预防卒中的Arctic Front Advance ST Cryoablation Catheter（冷冻球囊）刚刚获得了FDA和CE批准。冷冻球囊用于在微创介入手术中隔离心房肺静脉,使用冷却剂消融（或去除）与心房颤动相关的紊乱组织,而房颤与中风和心力衰竭关系密切。该器械的头端更短,设计帮助术者更好地实时观察及提高导管的操控性。
文摘Aim of the study: Several studies have shown the inferior performance of small prostheses in the narrowaortic root. However, modern low-profile mechanical prostheses have improved hemodynamic performance characteristics. By measuring the transprosthetic pressure gradient in vivo, we were able to characterize the hemodynamic features of two prostheses: the ATS Medical(ATS) and the Medtronic Hall(MH) valves. Methods: From October 1994 to April 2002, 113 patients received an aortic valve replacement(AVR) with either an ATS or a MH valve. The transprosthetic pressure gradients, calculated froma simplified Bernoulli equation during immediate postoperative Doppler echocardiographic examination, were compared for differently sized prostheses with respect to body surface area(BSA). Results: The mean pressure gradients and the mean BSAs were: 27.8±14.8 mm Hg and 1.50±0.10 m2 in ATS 19 mm(n=7), 20.4±8.5 mm Hg and 1.54±0.11 m2 in ATS 21 mm(n=22), 13.0±5.7 mm Hg, 1.70±0.13 m2 in ATS 23 mm(n=22), 10.9±3.5 mm Hg and 1.81±0.16 m2 in ATS 25 mm(n=19), 9.3±0.6 mm Hg and 1.72±0.17 m2 in ATS 27 mm(n=4), 13.5±6.5 mm Hg and 1.54±0.13 m2 in MH 20 mm(n=9), 10.9±4.7 mm Hg and 1.64±0.15 m2 in MH 22 mm(n=22), 9.3±3.1mmHg and 1.72±0.12 m2 in MH 24 mm(n=7). Conclusions: With the exception of the ATS 19mm valve, the variously sized prostheses have acceptable transprosthetic pressure gradient measurements. In addition, even-sized MH valves(20 and 22 mm) with a thinner sewing cuff showed better hemodynamic performances than similarly sized ATS valves.
