CS无支架心包二尖瓣应用研究  

Study on application of the CS stentless pericardial mitral valve

作　　者：龚光甫[1] 胡建国[1] 周新民[1] 刘锋[1] 李建民[1] 张伟[1] 王翔[1] 胡野荣[1] 陈晓凤[1] 

机构地区：[1]中南大学湘雅二医院胸心外科,湖南长沙410011

出　　处：《生物医学工程与临床》2005年第4期185-188,共4页Biomedical Engineering and Clinical Medicine

基　　金：卫生部临床学科重点项目基金(20012739);湖南省自然科学基金(97-284);湖南省科委基金[91-23-002-湖南省医药卫生基金(00042)]

摘　　要：目的比较传统有支架心包瓣与CS无支架心包二尖瓣的性能。方法测试瓣膜分为两组:A组,有支架心包瓣(与Ionescu-Shiley瓣相似);B组,无支架心包二尖瓣(与Quattro相似,由中南大学研制,简称CS瓣)。检测内容包括:①钙化倾向(SD鼠皮下埋藏模型);②组织学;③热皱缩温度;④断裂强度;⑤生物相容性;⑥血流动力学;⑦疲劳试验;⑧有限元分析。结果①B组钙化明显低于A组(P<0.01)。②组织学示A组心包片有大块钙化及胶元纤维裂解;B组仅见稍许钙化灶,胶原纤维保存完好。③热皱缩温度A组与B组无统计学意义。④断裂强度B组明显强于A组(P<0.005)。⑤内皮细胞种植后第1天,A组细胞明显少于B组(P<0.001);第3天A组已无细胞生长,B组内皮细胞增殖活跃;多数细胞Ⅷ因子检测呈阳性。⑥在模拟心输出量为2、4、6L,A组跨瓣压差明显高于B组(P<0.05),返流量和回流百分比A组显著高于B组(P<0.01),有效瓣口面积两组无统计学意义,仅在流量为4L时A组优于B组。⑦B组寿命比A组(n=2)长2.5倍。⑧B组瓣叶应力分布较为合理。结论CS无支架心包二尖瓣避免了应力集中区,其抗钙化、胶原纤维保存、断裂强度、生物相容性、血流动力学、疲劳寿命等均明显优于传统有支架心包瓣。Objective To compare the characteristics of the tranditional stented pericardial valve and the CS stentless pericardial mitral valve in vitro and in vivo. Methods Tested valves were divided into two groups,group A--stented pericardial valve (similar in Ionescu-Shiley valve); group B--stentless pericardial mitral valve (similar in Quattro;fabricated in Central South University). The following items of the valves were compared:①calcification trends;②histology;③heat shrunk temperature; ④breaking strength;⑤biocompatibility;⑥hemodynamics;⑦fatigue test;⑧finite element analysis. Results ①Valves in Group B were less calcified than that in group A(n = 10,P < 0.01).②Histology of valves in group A showed mass calcification and breaking down of collagen fibers,and only minimal calcification with collagen fibers was found in group B.③No significant difference on heat shrunk temperature between group B and A.④Breaking strength:the pericardium of group B was stronger than that in group A(P < 0.005).⑤On 1st day,after endothelial cells(ECs) transplantation the amount of seeding cells in group A was less than that in group B with significant difference(P < 0.001);on 3rd day,ECs were not found in group A,and ECs proliferated rapidly in group B,and most cultured cells showed positive factor Ⅷ related antigen reaction by immunohistochemistry assay.⑥There were 2,4,6 L at pulsatile flow,the transvalvular pressure gradient in group A were higher than that in group B with significant difference(P < 0.05). The regurgitant volume and regurgitant fraction in group A were higher than that in group B with significant difference(P < 0.01). There were no significant difference of EOA in group B and group A.⑦The life of valves in group B(n = 4) was 2.5 times longer than that in group A(n = 2). ⑧In group B valves showed more reasonable stress distribution than that in group. Conclusion The CS stentless pericardial mitral valves are avoiding from the concentrated stress area,and it's anticalcification,collagen fib

关 键 词：有支架 无支架 生物心脏瓣膜 

分 类 号：R318.0[医药卫生—生物医学工程]