A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aort...A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.展开更多
[目的]建立心肌肥厚-心衰动物模型,应用超声心动图动态观察兔心脏结构、血流动力学及心功能变化,探讨其演变规律.[方法]新西兰兔25只随机分为两组,手术组兔经侧腹部入路于肾动脉上方缩窄腹主动脉,术后观察动物行为学表现,定期复查超声,...[目的]建立心肌肥厚-心衰动物模型,应用超声心动图动态观察兔心脏结构、血流动力学及心功能变化,探讨其演变规律.[方法]新西兰兔25只随机分为两组,手术组兔经侧腹部入路于肾动脉上方缩窄腹主动脉,术后观察动物行为学表现,定期复查超声,动态观察腹主动脉及心脏超声改变.[结果]腹主动脉缩窄程度无明显改变,血流流速于4周后逐渐下降.左房内径（LAD）、左室后壁厚度（LVPW）及室间隔厚度（IVS）术后4周均增大,差异有显著性,6周后IVS增厚较LVPW明显,左室射血分数（EF）及左室短轴缩短率（FS）术后8周明显下降,Tei指数术后2周即开始显著增高（以上均 P 〈0.05）.[结论]经侧腹部入路缩窄腹主动脉制作兔心肌肥厚-心衰模型方法可行,成功率高,超声很好地反映了心脏心肌肥厚,心功能受损至心衰的一系列演变过程.展开更多
文摘A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.
文摘[目的]建立心肌肥厚-心衰动物模型,应用超声心动图动态观察兔心脏结构、血流动力学及心功能变化,探讨其演变规律.[方法]新西兰兔25只随机分为两组,手术组兔经侧腹部入路于肾动脉上方缩窄腹主动脉,术后观察动物行为学表现,定期复查超声,动态观察腹主动脉及心脏超声改变.[结果]腹主动脉缩窄程度无明显改变,血流流速于4周后逐渐下降.左房内径（LAD）、左室后壁厚度（LVPW）及室间隔厚度（IVS）术后4周均增大,差异有显著性,6周后IVS增厚较LVPW明显,左室射血分数（EF）及左室短轴缩短率（FS）术后8周明显下降,Tei指数术后2周即开始显著增高（以上均 P 〈0.05）.[结论]经侧腹部入路缩窄腹主动脉制作兔心肌肥厚-心衰模型方法可行,成功率高,超声很好地反映了心脏心肌肥厚,心功能受损至心衰的一系列演变过程.
文摘目的采用自体肺动脉补片矫治主动脉缩窄伴弓发育不良已取得较好的早中期效果。文中评估采用该术式的中远期疗效及可靠性。方法回顾性分析2009年5月至2017年5月期间广州军区总医院心血管外科中心收治的42例主动脉弓缩窄(Co A)伴主动脉弓发育不良患儿临床资料。按手术年龄分为高龄组(>1岁)和低龄组(≤1岁),比较2组患儿手术前后缩窄段压差、肺动脉压力及主动脉变化。结果本组患儿术后并发症8例,无围手术期死亡。随访4~106个月,平均(40.0±15.5)个月,期间无患儿死亡。主动脉缩窄处平均压差(11.9±6.4)mm Hg,5例缩窄处压差>25 mm Hg。患儿术后早期及远期随访主动脉缩窄处压差及肺动脉平均压均显著低于术前(P<0.05),远期随访主动脉弓部Z值较术前均明显增大(P<0.05),且远期随访横弓近端Z值明显大于术前[(-0.64±0.44)vs(-1.27±0.66),P<0.05]。相比于低龄组,高龄组患儿术前及近期随访具有较高的肺动脉压力(P<0.05),且高龄组患儿术中体外循环时间、主动脉阻断时间较长(P<0.05),术后呼吸机辅助时间、ICU时间及住院天数均延长(P<0.05);但远期随访低龄组患儿主动脉缩窄处压差较高(P<0.05),且主动脉横弓近端Z值及峡部Z值较低(P<0.05);两组患儿术中选择性脑灌注时间比较的差异无统计学意义(P>0.05)。结论主动脉缩窄伴弓发育不良患儿应尽早手术。采用自体肺动脉补片主动脉成形术是较理想的手术方式,可以获得较好的中远期效果。
