新型改良单层缝合无支架猪主动脉瓣的初步研究及体外测试  

Rudiment Research and in Vitro Evaluation of a New Improvement Single Layer Suture Stentless Porcine Aortic Bioprosthesis

作　　者：徐殊[1] 杨剑[1] 易定华[1] 谭红梅[1] 康晓军[1] 刘维永[1] 

机构地区：[1]第四军医大学西京医院心脏外科,西安710032

出　　处：《中国胸心血管外科临床杂志》2009年第2期118-122,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家863计划基金资助项目(2006AA02A138)~~

摘　　要：目的设计新型无支架猪主动脉瓣,改进其植入方法,并进行体外流体力学测试,评价其性能及可行性。方法6枚无支架猪主动脉瓣,根据植入缝合方法不同分为两组,单层缝合组:采用本实验中设计的新型改良单层缝合无支架猪主动脉瓣;双层缝合组:采用我科此前自行研制的新型无支架猪主动脉瓣;每组取直径为23mm、25mm和27mm瓣膜各1枚。术后用体外脉动流测试仪按照ISO5840的评估标准,分别检测两组瓣膜在心排血量(CO)为2.0L/min、3.5L/min、5.0L/min和7.0L/min的平均跨瓣压差、有效瓣口面积(EOA)和反流百分比等体外流体力学指标。结果单层缝合组瓣膜平均植入时间50min,双层缝合组70min。流体动力学测试结果显示:单层缝合组23mm瓣膜和27mm瓣膜在CO为5.0L/min时跨瓣压差均小于双层缝合组(13.51±0.51mmHgvs.14.44±0.99mmHg;7.36±0.19mmHgvs.7.53±0.28mmHg;P<0.01),EOA大于双层缝合组(1.87±0.06cm2vs.1.76±0.08cm2,2.26±0.07cm2vs.2.16±0.05cm2;P<0.01);其余测试条件下两组指标的测试结果差异无统计学意义。结论新型改良单层缝合无支架猪主动脉瓣具有天然的结构,表现出良好的血流动力学特性,改进后的单层缝合植入方法,缩短了植入时间,体外脉动流测试显示其平均跨瓣压差、EOA、反流百分比等体外流体力学数据与双层缝合法比较差异无统计学意义。该实验为今后的动物实验和临床试验打下了基础。Objective To design a novel stentless porcine aortic bioprosthesis and test the feasibility and its function in vitro after the valve was implanted by a modified method. Methods Six stentless porcine aortic bioprosthesis were divided into two groups according to different implantation, single layer suture group： new improvement stentless porcine aortic bioprosthesis sutured with single layer was implanted; double layer suture group： stentless porcine aortic hioprosthesis developmented by our laboratory used double layer suture was implanted. Each group contained three scales： 23 mm ,25 mm and 27 mm. Analogue ex vivo aortic valve replacement was performed , the feasibility of the new implantation was detected. Effective orifice area, transvalvular pressure gradient and regurgitation ratio were recorded at the cardiac output of 2.0 L/min, 3.5 L/min, 5.0 L/min and 7.0L/min under the guideline of International Organization for Standardization （ISO）5840. Results The average aortic valve implantation time used for single layer suture and tradition double layer suture were 50 rain and 70 min respectively. The transvalvular pressure gradient in the single layer suture group were significantly lower than those in double layer suture group under the flow of 5.0 L/minin 23 mm valve and 27 mm valve （13.51±0.51 mm Hg vs. 14.44±0.99 mm Hg, 7.36±0.19 mm Hg vs. 7. 53±0. 28 mm Hg;P〈0.01）;and the effective orifice area in the single layer suture group were larger than those in double layer suture group in the same case（1.87±0.06 cm^2 vs. 1.76±0.08 cm^2, 2.26±0. 07 cm^2 vs. 2.16±0. 05 cm^2;P〈0. 01）. There was no statistically difference in other parameters between both groups. Cunclusion The novel design of new improvement stentless porcine aortic bioprosthesis used single layer suture has good hemodynamic characteristics as the nature structure. The modified suture method decrease the implantation time. Nemerical data of the evaluation in vitro show that the difference between single layer suture grou

关 键 词：主动脉瓣 无支架 植入方法 体外测试 

分 类 号：R654.2[医药卫生—外科学]