适宜单层缝合置入的无支架猪主动脉瓣膜性能评价  

Properties of stentless porcine aortic valve for single-layer suture and implantation

作　　者：徐殊[1] 韩宏光[1] 王辉山[1] 

机构地区：[1]解放军沈阳军区总医院心外科,辽宁省沈阳市110001

出　　处：《中国组织工程研究》2013年第44期7667-7674,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:现有的生物瓣膜主要分为有支架和无支架两种。有支架瓣膜方便了手术操作,容易植入,植入后发生关闭不全的可能性小,但这种瓣膜并没有很好的模拟天然瓣膜。目的:为缩短瓣膜植入时间,进一步改善瓣膜性能,在参考猪主动脉根构型优化瓣膜设计的基础上,开发一种新型的适合单层缝合置入的无支架猪主动脉瓣膜,体外测试评估其性能。方法:①制备适合单层缝合的无支架猪主动脉瓣。②采用自行设计的新型单层缝合方法进行离体瓣膜植入实验。③对新型瓣膜进行体外流体力学测试及疲劳测试。结果与结论:适合单层缝合的无支架瓣膜在设计中去除了硬质的瓣架,可减轻血流冲击对瓣叶的损害,同时去除硬质瓣环后手术时可以植入口径更大的瓣膜,改善了血流动力学,较传统双层缝合瓣膜缩短了植入时间。经体外流体力学测试及疲劳测试,结果满意。但无支架生物瓣膜植入手术操作时间长、术后长期临床效果及耐久性尚需进一步临床结果验证。BACKGROUND： The artificial heart valve used in clinical application can be divided into stented and stentless. Stented valve is convenient for operations, with a low possibility of incompetency after transplantation. However stented valve cannot stimulate natural valve. OBJECTIVE： To reduce valve implantation time and improve valve properties, this study was designed to develop a new stentless porcine aortic valve for single-layer suture and implantation based on the design of valve in pig aortic root geometry optimization, and to further evaluate its performance by in vitro test. METHODS： （1） Stentless porcine aortic valve for single-layer suture was prepared. （2） The in vitro valve implantation experiment was performed with monolayer suture method. （3） The valve was detected by in vitro fluid mechanics test and fatigue test. RESULTS AND CONCLUSION： Stentless valve for single-layer suture has removed the valve hard, which contributes to reduce the damaged caused by blood flow on the valve leaflet, at the same time removal of the hard Valve ring can widen the diameter of implanted valve and improve hemodynamics, even the implantation time of valve is shorter than traditional double-layer suture. The in vitro fluid mechanics test and fatigue test results are satisfactory. The future research lies in a complete elucidation of long operation time, postoperative long-term clinical efficacy and durability of stentless valve implantation.

关 键 词：器官移植 心肺移植 主动脉瓣 生物瓣膜 心血管 无支架 植入方法 体外测试 

分 类 号：R318[医药卫生—生物医学工程]