单针单线缝合法和HP瓣在小瓣环主动脉瓣置换术中的应用  

Application of simple interrupted suturing combined with hemodynamic plus valve in aortic valve replacement in small aortic annulus

作　　者：周建华[1] 孙艺华[1] 陈海泉[1] 周贤[1] 

机构地区：[1]上海交通大学附属第六人民医院胸心外科,200233

出　　处：《上海医学》2007年第9期683-685,共3页Shanghai Medical Journal

摘　　要：目的探讨联合应用单针单线缝合法和HP(hemodynamic plus)瓣对小瓣环进行主动脉瓣置换术的效果。方法对17例小瓣环主动脉瓣病变的患者联合应用单针单线缝合法植入HP瓣进行主动脉瓣置换术。术中探查主动脉瓣瓣环直径为19～22mm。术后1周复查心脏超声。结果本组患者无手术死亡,无严重的并发症。术后左室舒张末径为(49.1±9.4)mm、左室重量指数为(80.6±18.6)g/m^2、主动脉瓣跨瓣峰值压差为(21.6±12.6)mmHg(1 mmHg=0.133 kPa),均较术前[(61.5±10.3)mm、(126.5±35.1)g/m^2、(82.6±52.6)mmHg]显著降低(P值均<0.01)。患者术后纽约心脏病协会(NYHA)心功能分级较术前明显改善(x^2= 42.610,P<0.01)。结论小瓣环主动脉瓣病变患者进行主动脉瓣置换时,联合应用单针单线缝合法植入HP瓣是一种安全、有效的术式。Objective To evaluate the outcome of simple interrupted suture technique combined with hemodynamic plus（HP） valve for aortic valve replacement in the small aortic annulus. Methods Seventeen patients with small aortic annulus received aortic valve replacement using HP valve combined with simple interrupted suture technique. The aortic annulus diameters were 19-22 mm as determined during operation. Doppler echocardiography was preformed in all patients one week after operation. Results There was no death or serious complication in our group. After operation, significant increases were observed after operation in the left ventricular dimension end diastole（[61.5 ± 10.3] mm vs [49. 1 ± 9.4] mm, P〈0.01）, left ventricular mass index（[126.5±35. 1] g/m^2 vs [80.6± 18.6] g/m^2 , P〈 0.01） and peak pressure gradients across aorticvalve（[82.6±52.6] mmHg vs[21.6 ± 12.6] mmHg, P〈0.01, 1 mmHg ： 0. 133 kPa）. The patients＇ heart function was significantly improved after operation according to NYHA cardiac function classing （Х^2 = 42. 610, P 〈 0. 01 ）. Conclusion Simple interrupted suture technique combined with HP valve is a safe, effective method for aortic valve replacement in small aortic annulus.

关 键 词：心脏瓣膜疾病 主动脉瓣 心脏瓣膜 人工瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学]