天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (6): 776-779.doi: 10.11958/20150341

• 应用研究 • 上一篇    下一篇

Perimount 牛心包瓣在二尖瓣置换术后的短期疗效研究

田彦超 1， 陈庆良 2， 陈彤云 2， 姜楠 2， 王联群 2   

  1. 1天津医科大学(邮编300070)； 2天津市胸科医院
  • 收稿日期:2015-11-20 修回日期:2016-03-10 出版日期:2016-06-15 发布日期:2016-07-04
  • 基金资助:
    天津市卫生局科技基金 （11KG125）

The short term outcome after mitral valve replacement with the perimount bovine pericardial valve

TIAN Yanchao1, CHEN Qingliang2, CHEN Tongyun2, JIANG Nan2, WANG Lianqun2   

  1. 1 Tianjin Medical University, Tianjin 300070, China; 2 Department of Cardiac Surgery, Tianjin Chest Hospital
  • Received:2015-11-20 Revised:2016-03-10 Published:2016-06-15 Online:2016-07-04

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摘要： 摘要： 目的 评价 Perimount 牛心包瓣在患者二尖瓣置换术后的短期疗效情况。方法 选取 88 例行 Perimount 牛心包瓣置换术患者， 记录患者 1 年病死率、 脑出血等一般情况。分别于术前、 术后 1 周、 3 个月、 1 年行超声心动图检查， 比较不同时间点患者纽约心脏病学会（NYHA）心功能分级、 左心房直径（LA）、 左室舒张末期直径（LVDD）、 左室收缩末期直径 （LVSD）、 左心室射血分数 （LVEF） 及肺动脉压力 （PAP） 情况； 术后 1 周、 3 个月及 1 年的最大跨瓣压差（PG）、 平均跨瓣压差（MG）、 最大跨瓣流速（PV）及有效瓣口面积（EOA）等血流动力学指标。结果 1 年内有 2 例（2.3%）死亡， 1 例死于脑出血， 1 例死于血栓栓塞； 瓣周漏 1 例（1.2%）， 无感染性心内膜炎和结构性瓣膜衰败发生。术后 3 个月及 1 年 NYHA 心功能分级改善 （P < 0.05）。与术前比较， 术后 1 周、 3 个月及 1 年 LA、 LVDD、 PAP 均降低（P < 0.05）； 术后 1 周 LVSD 、 LVEF 均降低（P < 0.05）； 术后 3 个月及 1 年 LVEF 均升高（P < 0.05）。与术后 1 周比较， 术后 3 个月及 1 年 LA、 LVEF 均升高（P < 0.05）。患者术后 1 周、 3 个月与 1 年的 PG、 MG、 PV 及 EOA 比较差异均无统计学意义。结论 Perimount 牛心包瓣应用于二尖瓣膜置换术后 3 个月和 1 年患者心功能恢复较好。

关键词: 心脏瓣膜, 人工, 二尖瓣, 超声心动图, 血流动力学, 心功能, 有效瓣口面积

Abstract: Abstract: Objective To evaluate the short term outcome after mitral valve replacement with the Perimount bovine pericardial valve. Methods Eighty-eight patients underwent mitral valve replacement with the bovine pericardial valve in hospital were included in this study. Postoperative general condition including mortality and cerebral hemorrhage was observed. The hemodynamic and New York heart disease association (NYHA) heart function classification were recorded by Doppler echocardiograms before operation, postoperative 1 week, 3 months and 1 year after mitral valve replacement. Values of the different time points of NYHA, left atrial diameter (LA), left ventricular end diastolic diameter (LVDD), left ventricular end systolic diameter (LVSD), left ventricular ejection fraction (LVEF) and pulmonary artery pressure (PAP) were compared. The hemodynamic parameters were also compared including the peak cross valve pressure (PG), mean cross valve pressure (MG), peak cross valve velocity (PV) and effective orifice area (EOA) 1 week, 3 months and 1 year after surgery. Results There were two cases (2.3%) dead in one year (one died of cerebral hemorrhage and another one died of thromboembolism). There was 1 perivalvular leakage (1.2%). There was no endocarditis or structural valve deterioration. NYHA cardiac function was improved at postoperative 3 months and 1 year (P < 0.05). The values of LA, LVDD and PAP were significantly decreased at postoperative 1 week, 3 months and 1 year compared with those before operation (P < 0.05). Values of LVSD and LVEF were significantly decreased at postoperative 1 week compared with those before operation (P < 0.05). The value of LVEF was significantly increased at postoperative 3 months and 1 year (P < 0.05). Compared with postoperative 1 week, the values of LA and LVEF were significantly increased at postoperative 3 months and 1 year (P < 0.05). There were no significant differences in PG, MG, PV and EOA between postoperative 1 week, 3 months and 1 year. Conclusion With the excellent performance of cardiac function recovery, left ventricular restoration and hemodynamic, the Perimount bovine pericardial valve remains a reliable choice as a mitral tissue valve.

Key words: valve prosthesis, cardiac, valve, mitral, echocardiogram, hemodynamic, heart function, effective orifice area