【摘要】 目的:总结连续缝合法在主动脉瓣生物瓣置换术中的应用经验。方法:28例心脏瓣膜病患者,单纯主动脉瓣置换术21例,双瓣(主动脉瓣及二尖瓣)置换术7例,均采用连续缝合法置换生物瓣。其中置换上21 mm生物瓣1例,23 mm 19例,25 mm 8例。结果:本组平均主动脉阻断时间(87±12)min,单纯主动脉瓣置换,无主动脉瓣钙化者主动脉阻断时间(36±4.6)min。无主动脉瓣周漏,置换21 mm生物瓣者跨主动脉瓣压差48 mmHg。其余患者跨主动脉瓣压差(10±4.3)mmHg。结论:主动脉瓣生物瓣置换中采取连续缝合法可置入比主动脉瓣瓣环内径大1～2 mm的生物瓣,获得较大的有效瓣口面积,可以有效降低跨瓣压力阶差,减轻左心室负荷,有利于心功能的恢复。更多还原

【Abstract】 Objective: to summarize the experience of continuous suture technique for bioprosthetic aortic valve(AV) replacement.Methods: Total 28 cases of heart valve disease,21 patients underwent aortic valve replacement and the other 7 patients concomitant cardiac procedures including mitral valve replacement,and all the cases adopted the continuous suture technique to repalce the bioprosthetic aortic valve.21 mm size aortic AV was used in 1patient,23 mm size aortic AV was used in 19 patients and 25 mm size in 8 patients.Results: The mean duration of aortic cross-clamp was(87±12) min,and the mean time was(36±4.6) min in the pure AV replacement cases without AV calcification.No perivalvular leakage was found after operation,the transvalvular pressure gradient in the patient replaced with 21 mm aortic valve was 48 mmHg,and the others were(10±4.3) mmHg.Conclusion: By using the continuous suture technique,the size of the valve implanted can be 1~2 mm larger compared with the aortic annulus.As a result,a much larger effective orifice area of the aortic valve and a lower transvalvular pressure gradient can be obtained.Consequently,cardiac function can be improved with left ventricular load reduced.更多还原