摘要
目的：评估无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换的安全性和临床效果。方法：以冠状动脉开口下方植入技术用无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换共８５例。剔除左、右冠状动脉窦保留完整的无冠窦，全部采用连续缝合方法。结果：４例术后３０日内死亡（４．７％），５例晚期死亡（６．２％）。余者超声心动图检查显示跨瓣压差较高者（平均压为６～２０ｍｍＨｇ）均下降，有效瓣口面积大于０．９ｃｍ２。１年后８６％有轻微的关闭不全，主动脉瓣完全能胜任血液动力学的需要。结论：无支架Ｍｅｄｔｒｏｎｉｃ生物瓣作主动脉瓣替换效果良好，适用于年龄超过７５岁以及伴有狭小主动脉根部的病人。
Aim:The purpose of the study was to evaluate the efficacy and safety of aortic valve replacement with medtronic freestyle bioprosthesis.Clinical material and method:The aortic valve was replaced with the medtronic freestyle bioprosthesis in 85 patients.The mean age of patients was 74 years(range,86 88 years).All bioprosthesis were implanted using the freehand subcoronary includes valve replacement technique,which includes removing the aortic sinus from the graft while leaving the non coronary sinus intact.Continuous suture technique was employed.Echocardiogram was performed to evaluate the function of the bioprosthesis during three year follow up.Results:There were four operative deaths with an operative mortality of 3.9%.Postoperative complications developed in 5 patients including central nervous system injury with paresis in 2,transient cerebral ischemia in 2 and upper gastrointestinal tract bleeding in 1.Late deaths occurred in 5 patients(4.7%).ECHO showed good hemodynamic performance of the prosthesis with low mean gradient(6 20mm Hg),and effective valve area(>0.9cm 2).The aortic valve was competent or with trifle incompetence by ECHO in 86% of patients one year after operation.Conclusion:These data show that the medtronic freestyle bioprosthesis is an excellent choice for replacement of the aortic valve,especially in patients over the age of 75 years or with small aortic root.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1999年第2期75-77,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
