牛颈静脉带瓣管道重建犬右心室流出道的血流动力学研究  

Hemodynamic study of right ventricular outflow tract reconstruction with valved bovine jugular vein conduit in canine model

作　　者：吴忠仕[1] 张竞超[1] 杨晓涵[1] 胡建国[1] 胡铁辉[1] 程端[1] 陈金兰[1] 徐新华[1] 李迎霞[1] 胡野荣[1] 

机构地区：[1]中南大学湘雅二医院心胸外科,长沙410011

出　　处：《中国胸心血管外科临床杂志》2004年第3期201-203,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：教育部国家重点学科建设基金资助(2002~203);湖南省科技基金资助项目(B2003~056)~~

摘　　要：目的　观察自制牛颈静脉带瓣管道重建犬右心室流出道后的血流动力学性能。　方法　应用经戊二醛处理的牛颈静脉带瓣管道对 7只犬行肺动脉与右心室连接 ,重建右心室流出道前后测定肺血流动力学 ,行超声心动图检查牛颈静脉带瓣管道通畅情况。　结果　重建术后 1年 7只犬均存活。重建右心室流出道前后肺动脉收缩压、舒张压和平均压均无明显改变 ,右心室舒张压无明显变化 ,收缩压和平均压显著增加 (P<0 .0 1)。术后超声心动图检查瓣膜关闭良好 ,无明显反流 ,跨瓣压差小 ;术后 1年超声心动图检测发现全部带瓣管道通畅 ,未见明显血栓形成 ,除 1只犬瓣叶活动稍差合并轻度反流外 ,其余犬瓣叶活动良好。心导管测压显示肺动脉与右心室之间压差为 3～ 19mm Hg(1k Pa=7.5 mm Hg) ,管道内舒张压显著高于右心室舒张压 ,右心室造影显示牛颈静脉带瓣管道和肺动脉无明显梗阻。Objective To investigate the hemodynamic performance of valved bovine jugular vein conduits (BJVC) for right ventricular outflow tract reconstruction in canine model. Methods The BJVC that were treated with the glutaraldehyde were implanted between the pulmonary artery and right ventricle in seven young canines. Right ventricular and pulmonary artery pressures were measured directly before and after the implantation. Hemodynamic evaluations were carried out by echocardiography and cardiac catheterization after the implantation. Results Seven canines were survival one year after the implantation. The pulmonary artery pressures (including systolic pressure, diastolic pressure and mean pressure) had not significantly changed after reconstruction with the conduits. The right ventricular diastolic pressures had not increased after the reconstruction, but the right ventricular systolic pressure and mean pressure had increased. One year later, the echocardiography showed valve motion with no obvious thickening of the leaflets. No graft kinking or obvious regurgitation of the valve was observed. Cardiac catheterization and angiography showed that the pressure gradients between the right ventricle and the conduits varied from 3 to 19mmHg, the diastolic pressures in the conduits were higher than that of right ventricle((P<)0.01), and the conduits and pulmonary arteries had no obvious obstruction. Conclusion The glutaraldehyde-fixed bovine jugular vein conduit has good hemodynamic performance in the pulmonary circulation.

关 键 词：牛颈 静脉带瓣管 犬 右心室流出道 血流动力学 BJVC 超声心动图 

分 类 号：R654.2[医药卫生—外科学]